Kelen et al developed a classification of inpatients that can be used to guide transfer the patients out of the hospital (reverse triage) during a critical surge in admissions. This can help minimized serious complications as a result of the transfer. The authors are from the Johns Hopkins University in Baltimore.
Patient Condition |
Risk of Consequential Medical Event |
Risk Group |
no or minimal risk of a medical event during the next 72 hours without care |
minimum |
1 |
requires intermittent care but no critical interventions |
low |
2 |
requires a critical intervention but not continuous care |
moderate |
3 |
requires continuous, uninterrupted skilled care |
high |
4 |
unstable for transport, cannot be moved or cannot be readily transferred |
very high |
5 |
Risk Group |
Transfer Point |
Transfer Mechanism |
1 |
discharge home |
self, family or friends |
2 |
low acuity facility; some can be discharged home |
depends on available resources |
3 |
moderate care facility |
regular ambulance |
4 |
major acute care facility |
transfer with skilled attendance |
5 |
do not transfer OR send to a major acute care facility |
only use ICU-capable transport |
Specialty: Critical Care, Emergency Medicine
ICD-10: ,