Workup by a transplant team for uncommon infections and conditions which are standard to them but obscure to others
Access to a transplant surgeon to biopsy the transplant and assess for rejection
Access to pathologists used to working with transplants
Continuity of care for their 700th admission since transplant
Salvage procedures for the transplant that a transplant team is familiar with that other physicians may not be
I think the care complexity of these patients tends to be underestimated often. It’s like arguing that bariatric surgery doesn’t need a bariatric center. Might be technically true but the outcomes just aren’t going to be the same.
There probably isn’t a legal/emtala burden to accept outside the acute phase, but I would argue that especially in the first year or so after transplant there actually is one. Even after though, I think there’s the moral burden of what’s really right for the patient and I absolutely think that’s transfer to a mothership that deals with this crap.
If the workup takes longer than 4 hours it’s inappropriate for the Ed, and increases mortality for the patient as well as everyone in the waiting room not getting proper care.
If the workup takes longer than 4 hours it’s inappropriate for the Ed, and increases mortality for the patient as well as everyone in the waiting room not getting proper care.
Is that so? Based on? And why do you need 4 hours for a workup? Does a study differentiating AKI types require 4 hours? HF exacerbation etiology? And some of the other incomplete examples provided by author? I rarely got an ED patient after 4 hours of workup. Most of time, 10 minutes if anything....