Bridging the Gap: Improving Family-Physician Communication During Hospital Transfers
"Learn how better communication and shared decision-making can ease the stress of interfacility transfers for children with special healthcare needs and their families."
For families of children with special healthcare needs (CSHCN), hospital visits can be a frequent part of life. When a child needs specialized care that their local hospital can’t provide, they often undergo what’s known as an interfacility transfer—moving to a hospital equipped to meet their specific needs. While these transfers are meant to ensure the best possible care, they can also be incredibly stressful for families. Effective communication between families and physicians is essential to ease this stress.
A recent study published in "Hospital Pediatrics" sheds light on the experiences of families and physicians during interfacility transfers. Researchers explored the perceptions of both groups to identify areas for improvement in the transfer process, focusing on how family-physician interactions can be optimized to create a more supportive and patient-centered experience.
The study highlights the importance of shared decision-making, understanding families' resource needs, and clear communication. By addressing these key areas, hospitals can reengineer their transfer systems to better support families and ensure smoother transitions for children with special healthcare needs.
Communication Across Transfers
Family members of nursing-home residents can influence hospital-transfer decisions, although their influence varies. They also serve as an important communication link between residents and medical staff and between nursing homes and hospitals. Research on rural families examines which communication processes are most acceptable during interhospital transfers of critically ill patients, while a 2026 dashboard study identified quality metrics for medical intensive care unit transfers through a multidisciplinary team.
Defining Transition Communication
A 2020 review defines transition communication as the verbal and written forms of communication, or the processes, used to convey care needs, assessments, and evaluations during periods of care transition. The review included articles concerning patients of all ages and health conditions. A 2019 systematic review focused specifically on how family members experience and influence transfers from nursing homes to hospitals and how they participate in transfer decisions.
Why Family-Physician Communication Matters During Hospital Transfers
The study involved interviews with referring physicians (those sending the child to a specialist facility), accepting physicians (those receiving the child), and family caregivers. The researchers identified three main categories that significantly impact the transfer experience:
- Shared Decision-Making: Families want to be active participants in decisions about their child's transfer, including whether a transfer is necessary, which hospital is best suited for their child's needs, and the mode of transportation. When families are involved in these decisions, they feel more in control and less stressed.
- Awareness of Families' Resource Needs: Transfers can create significant financial and logistical burdens for families, including travel expenses, lodging, childcare, and time off work. Hospitals that are aware of these needs can offer resources and support to help families manage these challenges.
- Communication: Clear, frequent, and bidirectional communication is essential throughout the transfer process. Families need to be kept informed about their child's condition, the reasons for the transfer, what to expect during the transfer, and the plan of care at the receiving hospital.
Family-Centered Transfer Research
Recent research on inter-facility transfers of critically ill children identifies shared decision-making, responsiveness to resource needs, and consistent communication as necessary elements of patient- and family-centered care. A qualitative study of pediatric trauma transfers examined how that specific context can create complications in information exchange. Separately, a nurse-to-family telehealth intervention for pediatric transfers underwent iterative adaptations until workshop participants and 67 other stakeholders indicated that no further improvements were needed.
Handoff Communication Failures
Communication failures during patient handoffs have frequently been implicated in adverse events. A systematic review examined the less-studied problem of adverse events arising when patients are transferred between hospital units, rather than only during shift changes. The review also characterized factors affecting handoff communication and assessed the effectiveness of existing interventions.
Patient Preferences for Family Presence
A survey of patients examined family involvement in routine health care by asking about their behaviors and preferences. The majority of respondents, 55%, said they would prefer to have a friend or family member in the examination room for some visits. This finding indicates that preferences for family participation can vary by visit rather than representing a universal choice for every encounter.
Practical Steps for Improving Family-Physician Communication During Transfers
So, what can hospitals and healthcare providers do to improve family-physician communication during interfacility transfers? The study authors offer several recommendations: Implement standardized transfer protocols: Standardized protocols can ensure that families receive consistent information and support throughout the transfer process. Provide training for healthcare providers: Training can help providers better understand the challenges faced by families during transfers and how to communicate effectively with them. Offer resources and support: Hospitals can provide resources such as gas cards, meal vouchers, and lodging assistance to help families manage the financial burdens of transfers. Utilize telemedicine: Telemedicine can facilitate two-way communication between families and specialists at the receiving hospital, providing reassurance and answering questions. Encourage shared decision-making: Providers should actively involve families in decisions about the transfer, valuing their input and preferences.
From Experience to Safer Transfers
Inter-hospital transfers are increasingly common, and improving them while reducing adverse events and inappropriate transfers remains a research and clinical-practice priority. Research on family members' lived experiences during interhospital transfer can help intensive-care personnel prepare for family-centered care and can inform clinical-practice guidelines. A 2025 mixed-methods study examined the interfacility transfer process through topics including consent at the referring hospital and the experiences of patients and care partners.
Evolving Communication Systems
Healthcare communication trends identified for 2026 focus on shifts reshaping patient engagement and on how modern communication systems may improve care coordination, efficiency, and patient experience. The 15th Annual Spok Healthcare Communications Report examines motivations, concerns, strategies, and solutions shaping healthcare communication, including challenges facing U.S. health systems, frontline clinical workers, and back-office IT teams. A 2025 study of hospital communication research highlights the field's growing importance for patient safety, care quality, and organizational efficiency.
Persistent Information Gaps
Inter-hospital transfers are increasingly common and represent a high-risk care transition. Reported systemic challenges include persistent communication gaps, non-standardized processes for information exchange, and a lack of protocols for communicating timely reassessments of patients waiting for transfer. These challenges have made improving inter-hospital transfers, reducing adverse events, and limiting inappropriate transfers a continuing research and clinical-practice priority.