# Improving Interhospital Transfer of Patients with Neurologic Emergencies

> **NIH AHRQ K08** · NORTHWESTERN UNIVERSITY · 2023 · $149,413

## Abstract

PROJECT ABSTRACT: More than 2.3 million patients experience an interhospital transfer (IHT) each year in
the United States. Most IHTs originate from the Emergency Department and neurologic emergencies (NE) are
one of the most common reasons for transfer. During IHT, exchange of information and clinician
communication are often poor, which may contribute to the associated poorer outcomes compared to patients
who are admitted directly to tertiary hospitals. While IHTs have been studied for highly time sensitive
conditions including trauma, acute ischemic stroke (AIS), and myocardial infarction, little work has focused on
non-AIS NEs, such as hemorrhagic stroke, traumatic intracranial hemorrhage, or seizures. This project seeks
to gain an understanding of the IHT process for non-AIS NE by conducting a Failure Modes and Effects and
Criticality Analysis (FMECA) to identify, characterize, and rank order the highest risk failures. A select number
of identified high risk failures will be targets for the application of human-centered design to develop an
intervention. Finally, the applicant will use an implementation framework to implement the intervention and then
conduct a feasibility study using a hybrid implementation effectiveness analysis approach to assess both the
preliminary effectiveness and the implementation. The overall goal of this project is for the applicant, an
emergency medicine physician-scientist, to become a leader in robust methods for risk-assessment of
healthcare delivery systems and processes, the application of cutting-edge human-centered design
approaches, and implementation science to advance the quality and safety of emergency care while improving
patient-centeredness. Under the supervision of primary mentor, S. Prabhakaran, MD, MS, and co-mentors J.
Holl, MD, MPH, A. Naidech MD, MSPH, and D. McCarthy, MD, MS, the applicant will leverage the world-class
institutional strengths of Northwestern University to improve his skills in risk assessment for healthcare
quality and patient safety, human-centered design, implementation science, and prospective study
design. With these skills, the applicant will be ideally positioned to become an independent health services
and outcomes researcher, focused on the development and testing of novel healthcare delivery interventions in
emergency medicine. This proposal combines a highly motivated, exceptionally qualified candidate, an
experienced mentorship team, and novel methods to improve the systems and processes of care during the
IHT of patients with non-AIS NE, an increasingly common healthcare practice as regionalization of advanced
and specialty care increases.

## Key facts

- **NIH application ID:** 10696108
- **Project number:** 5K08HS029208-02
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Peter B Pruitt
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2023
- **Award amount:** $149,413
- **Award type:** 5
- **Project period:** 2022-09-30 → 2027-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10696108

## Citation

> US National Institutes of Health, RePORTER application 10696108, Improving Interhospital Transfer of Patients with Neurologic Emergencies (5K08HS029208-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10696108. Licensed CC0.

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