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July 3, 1987


JAMA. 1987;258(1):42-43. doi:10.1001/jama.1987.03400010046014

To the Editor.—  As one charged with the responsibility of devising and implementing a new policy at Cook County Hospital, Chicago, for the transfer of patients from other hospitals, I feel compelled to add additional information to the present debate. In their original article1 and policy article,2 Drs Ansell and Schiff outlined the negative consequences for patients transferred to Cook County Hospital from other hospitals. What was not mentioned in either article were the following facts:

  1. At the time of the study, Cook County Hospital had no formal mechanism for accepting patients from other hospitals. Attending and senior physicians were not assigned the responsibility of accepting patients, this often being delegated to inexperienced staff.

  2. Little or no attempt was made to screen seriously ill transfers from those who might not even require admission. Often no special provisions were made for patients seriously ill during transport.