AZ REACH marks one-year anniversary with nearly 6,000 rural patient transfers

Celebrating its one-year anniversary, the Arizona Resource Equity and Access Coordination Hub (AZ REACH) is marking the occasion with nearly 6,000 patient transfer requests, dramatically improving access to care for hospitalized Arizonans and easing the administrative burden on providers, particularly in rural areas.

The Arizona Poison and Drug Information Center at the R. Ken Coit College of Pharmacy partnered with the Arizona Department of Health Services and Blackbox Healthcare Solutions in December 2022 to launch AZ REACH, a statewide program aimed at enhancing equitable access to care for rural communities. The program has helped improve health care access for thousands of Arizona patients. 

AZ REACH emerged from the transformative experiences of the Arizona Surge Line, a centralized transfer center that played a pivotal role in load-leveling hospitals and facilitating patient transfers during the COVID-19 pandemic. Throughout the pandemic, 85% of transfer requests originated from Rural, Indian Health Services, Tribally Operated PL-638, and Critical Access Hospitals, revealing a significant disparity in access to care for rural Arizonans. In response to this need, state and federal grants were utilized to establish AZ REACH.

"It cannot be overstated how crucial the Arizona Surge Line was in getting patients access to the lifesaving care they needed," said principal investigator Steven Dudley, PharmD, DABAT, director of the Arizona Poison and Drug Information Center. "These hospitals made it clear how desperately needed this was for all conditions, not just COVID. Thus, AZ REACH was born."

Since its inception, the program has experienced continuous growth. In October, state funding from Arizona Representative Julie Willoughby expanded services to hospitals with 20 beds or fewer. This expansion, known as the Arizona Statewide Transfer Escalation Pathway (AZ STEP), broadened the program's services to an additional five smaller rural hospitals, increasing the total number of participating facilities to 28. 

“As a nurse, I know that the AZ REACH program helps save practitioners time and patients’ lives,” said Representative Willoughby. “With the introduction of AZ STEP, we are taking a monumental step towards improving patient care, throughput, and access to specialty services, particularly in our smaller rural hospitals.” 

In its first year, AZ REACH: 

• Transferred 5,298 patients — 91 percent of the 5,804 requests received.
• Identified the most needed medical services as cardiology, gastrointestinal, general surgery, pulmonology, and neurology – accounting for 52% of all requests.
• Completed transfer requests with a median time of 1.2 hours — equating to 6,000 hours or 250 days of time given back to hospital staff to focus on direct patient care

The impact of AZ REACH is evident. Hospitals are experiencing improved patient transfers, allowing clinicians to concentrate on delivering essential care at the bedside rather than dealing with administrative tasks, which are now efficiently managed by dedicated AZ REACH personnel.

Sasha Reid, DO, is the medical director for the Wickenburg Community Hospital Emergency Department. Her hospital jumped at the chance to partner with AZ REACH. 

“We were burdened with calling transfer centers…to secure transfer placement for a patient needing a higher level of care than we could provide in Wickenburg,” she said. “The time staff members spent on the phone took away from the time they were available to provide direct patient care.” 

AZ REACH provides a strong framework for swift activation during hospital admission surges caused by events like mass casualty incidents, seasonal increases or potential future pandemics. This was demonstrated when AZ REACH effectively responded to the surge in pediatric hospitalizations during the previous respiratory syncytial (RSV) and influenza season, assisting providers and patients regardless of the hospital they came from.

“The AZ REACH team has become an integral part of patient care for those needing transfer to larger facilities with more resources than we have at our critical access hospital,” Reid said. “We cannot thank them enough for all efforts so far and are looking forward to any expansion opportunities the team creates.”

AZ REACH tracks numerous metrics such as patient demographics, required medical specialties, care levels and total transfer times. This provides a deeper understanding of the status of Arizona's health care system for county and state health departments and enables the early detection of brewing surges in hospitalizations. It also simplifies some of the daunting complexities of health care coordination that contribute to worse patient outcomes.

The program embodies the commitment of Arizona's clinical medicine and public health communities to the concept of equity. It strives to ensure swift and equitable access to care for vulnerable populations and hospitals, embodying the true essence of compassion in health care.

“In underserved communities, health care provider shortages exacerbate the existing disparities,” said Charley Larsen, MSN-L, MBA, RN, NE-BC, chief nursing officer of Blackbox Healthcare Solutions and executive lead for AZ REACH. “Our program strives to ease administrative burdens on emergency care providers, granting them greater time and focus at the bedside to care for those in need.”