Critical Access Hospitals: Keeping Care Local, Reducing Low-Acuity Inter-Hospital Transfers

Date of Award

Summer 2025

Document Type

Dissertation

Degree Name

Doctor of Healthcare Administration (DHA)

Committee Chair

Crissie Jameson

Committee Member

Melody Rose

Committee Member

Alyncia Bowen

Abstract

When a patient seeks treatment in a rural critical access emergency department, they may encounter various disposition options based on the acuity of their condition or the patient care services required. These options include but are not limited to: 1) discharged home with no follow-up care needed, 2) discharged home with a required follow-up appointment or testing, 3) admitted to the hospital, or 4) transferred to another hospital for a higher level of care or service (known as an inter-hospital transfer). Such inter-hospital transfers can be stressful for the patient, their family, and healthcare organizations for several reasons, particularly if an alternative care option could have been available instead of the inter-hospital transfer. After the COVID-19 pandemic, the healthcare industry continues to be plagued by staffing shortages, increased inflation, and rising healthcare costs. These challenges have intensified the need for healthcare organizations to explore innovative ways of providing patients with more cost-effective care closer to home. An example of one of these opportunities is the reduction of avoidable low-acuity inter-hospital transfers from rural critical access hospitals to tertiary/quaternary facilities. This research employed an exploratory study methodology to learn how emergency department providers describe patient care resources or services that might exist or be required in rural critical access hospital emergency departments to support the reduction of low-acuity inter-hospital transfers to tertiary/quaternary hospitals.

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