Table of Contents
A systematic review covering 12,313 intrahospital transports reported a pooled adverse-event frequency of 26.2%. Another major study found just 9.6%. The difference exposes a question every hospital should be asking: are we measuring patient transport safety correctly?
A patient is stable in the intensive care unit.
The clinical team determines that a CT scan is necessary.
Monitoring equipment is prepared. Oxygen and medication infusions must remain available. The patient's lines, tubes and connected devices need to be secured.
The transport team moves the patient into a corridor.
An elevator arrives. A monitor sounds. Someone adjusts an infusion device.
The journey continues.
For most people, moving between hospital departments may seem like a routine activity. But for a critically ill patient, intrahospital transport means temporarily recreating essential elements of critical care outside the intensive care unit.
And that creates risks.
In 2022, researchers published a systematic review and meta-analysis covering 12,313 intrahospital transports involving 1,898 critically ill patients across 24 studies.
The pooled frequency of adverse events was 26.2%.
Yet a separate multicentre investigation published in 2023 recorded adverse events during approximately 9.6% of transports.
Why such a substantial difference?
Because adverse events are not always defined or measured in the same way.
A temporary blood-pressure abnormality, equipment malfunction, communication problem and life-threatening emergency may all appear in adverse-event reporting.
But they are not equivalent outcomes.
An adverse event, a safety hazard and actual patient harm must not be treated as interchangeable concepts.
This article examines what the published research actually tells us, how transport risks arise and what hospitals can do to improve safety.
It also introduces a practical transport-safety review framework and examines where stretcher design, monitoring equipment and clinical workflows fit into the wider safety system.
Quick Answer: How Risky Is Intrahospital Transport for ICU Patients?
Intrahospital transport can expose critically ill patients to physiological deterioration, equipment problems, interruptions in monitoring, communication failures and environmental hazards.
A 2022 meta-analysis found a pooled adverse-event frequency of 26.2%, but results varied enormously between studies.
A separate 2023 multicentre observational study reported adverse events during approximately 9.6% of transports.
Neither figure represents a universal probability that a patient will be injured.
Many recorded events are not life-threatening. Some safety hazards may be identified and corrected before they cause measurable harm.
The risk depends on the patient's clinical condition, transport urgency, available equipment, accompanying personnel, monitoring requirements and destination.
Professional guidance published in 2025 recommends structured assessment, appropriate staffing, reliable equipment, coordinated communication and consistent transport procedures.
The goal is not to eliminate medically necessary patient transfers. It is to maintain essential care throughout the journey and reduce avoidable risks.
What 12,313 Hospital Transfers Reveal: Six Essential Research Findings
1. The pooled adverse-event frequency was 26.2%
Murata and colleagues conducted a systematic review and meta-analysis published in the American Journal of Emergency Medicine in 2022.
The research included 24 studies involving 12,313 transport episodes and 1,898 critically ill patients.
The pooled adverse-event frequency was 26.2%, with a 95% confidence interval of 15.0% to 39.2%.
This estimate was produced through meta-analysis.
It is not a simple observation that exactly 26.2% of all 12,313 transports caused harm.
The study also focused on critically ill patients. Its findings should not automatically be extended to stable patients undergoing routine hospital transport.
2. The studies showed exceptionally high variation
The same meta-analysis reported an I² statistic of approximately 99.5%.
This indicates extremely high statistical heterogeneity.
The individual studies produced markedly different estimates, potentially influenced by patient characteristics, transport conditions, definitions and research methods.
Such variation limits how confidently the pooled percentage can be applied to any individual hospital.
A hospital should therefore not assume that its expected adverse-event frequency is 26.2%.
Nor should it automatically interpret a lower reported rate as evidence of superior clinical performance.
3. Life-threatening adverse events were much less frequent
The meta-analysis estimated a pooled frequency of life-threatening adverse events of approximately 1.47%.
The associated 95% confidence interval was 0.43% to 2.95%.
The review also reported a pooled estimate of zero for deaths attributed to transport within the included analyses.
This does not prove that transport-related deaths cannot occur.
Rare outcomes require cautious interpretation, particularly when study methods and populations differ.
Nevertheless, the distinction is important.
An event requiring clinical observation is not equivalent to cardiac arrest or another life-threatening complication.
4. A separate study reported adverse events during 9.6% of transports
The multicentre I-TOUCH study was published in the Indian Journal of Critical Care Medicine in 2023.
Researchers examined 1,065 intrahospital transport episodes involving 893 patients across 15 tertiary care centres in India.
Adverse events were recorded during 102 transports, corresponding to approximately 9.6%.
The reported categories included 31 cardiovascular events, 18 respiratory events, 17 neurological events and 13 equipment-related events.
Two patients experienced cardiac arrest in connection with transport.
Some transports involved more than one event category.
This was an observational study, and its results describe the participating patient population rather than every hospital environment.
5. Emergency transport was associated with higher adverse-event odds
The I-TOUCH researchers found an association between emergency transport and adverse events.
The adjusted odds ratio was approximately 5.11, with a 95% confidence interval of 3.32 to 7.88.
This does not mean that emergency transport universally causes five times as many complications.
Patients requiring urgent transport may already be clinically unstable.
Disease severity, treatment requirements and other factors can influence the relationship.
The finding supports greater attention to preparation and clinical risk assessment without suggesting that time-critical care should be unnecessarily delayed.
6. Researchers identified 365 safety hazards during only 51 transports
A separate prospective observational study published in Critical Care Medicine in 2017 examined intrahospital transport at a Swedish university hospital.
Researchers identified 365 safety hazards during 51 transport episodes.
The median was seven hazards per transport.
The hazards involved multiple components of the healthcare work system.
Importantly, detecting seven hazards does not mean that seven adverse events occurred or that the patient experienced seven injuries.
A hazard may exist without producing an adverse event.
The study therefore provides a different type of insight from research focusing on physiological complications.
Together, these findings show why patient transport safety cannot be understood through a single percentage.
Sources: Murata et al., 2022, I-TOUCH, 2023 and Bergman et al., 2017.
Why Do Studies Report 26.2% and 9.6%?
The difference is striking, but it is not necessarily contradictory.
The 2022 meta-analysis combined studies conducted in different healthcare environments using different adverse-event definitions.
The 2023 I-TOUCH investigation followed a specific prospective protocol across participating hospitals.
Their populations and reporting practices were not identical.
Consider a temporary decline in oxygen saturation.
One research protocol might classify it as an adverse event when a predefined threshold is crossed.
Another might require intervention or a more sustained abnormality.
An equipment alarm could be classified as a technical event, while a device disconnection might be recorded separately.
A communication problem could be considered an operational hazard even if it caused no measurable patient harm.
These distinctions influence the reported frequencies.
Adverse event, safety hazard and patient harm
An adverse event is an undesirable occurrence defined according to a particular clinical or reporting framework.
A safety hazard is a condition that creates or increases the possibility of an undesirable outcome.
A near miss is an incident or circumstance that could have led to harm but did not produce that outcome.
Patient harm refers to an actual adverse effect on the patient.
The exact definitions may differ between reporting systems.
Hospitals should establish their definitions before collecting statistics or comparing departments.
They should also distinguish events occurring during transport from events demonstrably caused by transport.
A patient can deteriorate during a journey without the movement itself being the sole cause.
What the Anesthesia Patient Safety Foundation adds
In February 2025, the Anesthesia Patient Safety Foundation published a review discussing intrahospital transport, adverse-event definitions, checklists and perioperative safety.
It highlighted the variation in reported event rates and the importance of distinguishing clinically significant events from broader reporting categories.
The review also demonstrated why ICU transport research cannot automatically be generalised to every perioperative journey.
The clinically useful question is not simply how often an event occurs, but what happens, how serious it is and which factors can be changed.
Source: Anesthesia Patient Safety Foundation — Intrahospital Patient Transport.
Why Critically Ill Patients Face Different Transport Risks
Hospital transport is not one uniform clinical activity.
A stable patient travelling from a general ward to an outpatient imaging department has different requirements from a ventilated ICU patient receiving several medication infusions.
The difference begins with clinical complexity.
Optium's analysis of how ICU beds differ from standard hospital beds explains why increasing patient acuity changes equipment and caregiver requirements.
The same principle applies to transport.
Physiological instability
Critically ill patients may have unstable cardiovascular, respiratory or neurological function.
Their condition can change during transport, whether or not the journey itself causes the deterioration.
Appropriate clinical assessment and monitoring are essential.
Respiratory support
Some patients require oxygen therapy, non-invasive ventilation or invasive mechanical ventilation.
Transport planning must consider the necessary respiratory support throughout the journey.
Equipment preparation, oxygen availability and accompanying clinical expertise must match patient needs.
Connected medical devices
A patient may have multiple catheters, infusion lines, monitoring leads, drains and respiratory connections.
Movement creates opportunities for these devices to become caught, pulled or disconnected.
Their security and arrangement should be assessed before transport.
Monitoring and alarms
Transport can change the configuration of the monitoring environment.
Portable equipment must provide the observations necessary for the patient's clinical condition.
However, a large number of technical alarms does not necessarily equal better safety.
Optium's research on hospital alarm fatigue and monitoring overload explores the difference between meaningful clinical warnings and excessive non-actionable alerts.
During transport, teams need monitoring information they can interpret and act upon.
Staffing and clinical support
The transport team must have the skills required by the patient's condition.
The availability of qualified personnel may differ between departments and shifts.
Optium's analysis of the global nursing shortage and staffed hospital capacity provides broader context for why physical equipment availability and clinical staffing are separate considerations.
A transport surface cannot compensate for missing clinical expertise.
The risk is not created by movement alone. It arises from the interaction between the patient, clinical support, equipment and environment.
The Five Systems Behind Patient Transport Hazards
The 2017 study by Bergman and colleagues provides a useful framework for examining why transport hazards develop.
Researchers categorised the 365 observed hazards according to different components of the healthcare work system.
1. Tools and technology — 124 hazards
This was the largest category.
Potential problems may involve monitoring equipment, infusion devices, respiratory support systems or transport-related technology.
However, the study did not identify 124 stretcher failures.
The equipment category covered a wider clinical technology environment.
This matters for procurement.
Hospitals should evaluate how devices work together, not simply whether each item is individually available.
2. Tasks — 83 hazards
Tasks include the activities involved in preparation, movement, monitoring and handover.
Problems can develop when essential checks are omitted, interrupted or performed inconsistently.
Standardising important preparation steps may support more reliable workflows.
3. Teams — 61 hazards
Team-related hazards can involve communication, responsibilities and coordination.
Even experienced healthcare professionals may face problems if responsibilities are not clearly assigned.
A transport process should identify who is responsible for clinical monitoring, equipment and communication.
4. Organisation — 49 hazards
Organisational issues can involve the systems supporting transport.
A receiving department may not be ready.
Necessary resources may be unavailable.
A transfer may be delayed by factors outside the immediate control of the transporting team.
Optium's research on emergency department boarding and hospital-wide patient-flow delays demonstrates how operational problems in one department can affect care elsewhere.
5. Environment — 48 hazards
The physical hospital environment creates its own challenges.
Corridors, elevators, doorways, crowded clinical areas and limited working space can complicate patient movement.
Hospital design also affects staff workload.
Optium's investigation into how far nurses walk during a hospital shift examines how layouts, interruptions and repeated journeys shape clinical work.
The central lesson is that hospital transport safety is a systems-design problem rather than simply an individual handling problem.
ICU to CT Scan: A Patient Journey Worth Auditing
Diagnostic imaging is a frequent reason for critically ill patients to leave the ICU.
In the I-TOUCH study, approximately 71.3% of recorded transports were performed for diagnostic imaging.
That makes the journey between intensive care and radiology particularly useful for operational analysis.
Before leaving the ICU
The clinical team should determine whether transport is necessary and evaluate its expected benefits and risks.
The patient is assessed, required clinical support is prepared and the receiving department is contacted.
The team should understand the intended route and its logistical requirements.
During movement
Clinical support must continue as appropriate.
The transporting team may need to navigate corridors, elevators and other hospital activity while managing connected equipment.
The transport surface must be appropriate for the patient and journey.
At the imaging department
The receiving team should be ready.
Patient positioning and equipment compatibility depend on the intended examination.
Some examinations may require transferring the patient onto another surface.
Others may be possible using compatible equipment without additional movement.
During the return
The journey back to the ICU remains part of the transport episode.
Monitoring, communication and clinical support continue to matter.
On arrival, the patient and relevant equipment should be reassessed according to institutional procedures.
Can X-ray-compatible stretchers reduce handling?
Certain radiolucent stretcher platforms can support specific radiographic examinations without moving the patient onto another surface.
This may remove a handling step when the examination and equipment configuration allow it.
However, X-ray compatibility does not automatically imply CT or MRI compatibility.
MRI environments require separate safety assessment, and CT examinations generally have their own positioning requirements.
Optium's guide to X-ray-compatible hospital stretchers explains why the exact platform design, imaging requirements and workflow should be examined before purchase.
The safest approach is not necessarily to eliminate every movement. It is to avoid unnecessary handling while maintaining appropriate clinical care.
What the 2025 Critical Care Transport Guidance Recommends
In April 2025, the Indian Society of Critical Care Medicine published a position statement addressing the intrahospital transport of critically ill patients.
The document includes 38 recommendations covering preparation, assessment, transport teams, monitoring, equipment, communication and post-transport considerations.
Several principles are particularly relevant for hospital quality-improvement teams.
Assess the need for transport
The treating team should evaluate whether the proposed transport is clinically indicated.
The expected benefits should be considered alongside patient-related risks.
Where clinically suitable alternatives exist, they may be evaluated.
Assess and prepare the patient
The patient's clinical condition should be reviewed before departure.
Required monitoring, respiratory support and medication systems should be prepared according to clinical needs.
Assign appropriate personnel
The guidance suggests at least two team members for ICU transport, including the ICU nurse assigned to the patient.
It also addresses advanced life-support competencies and the need for medical accompaniment for certain unstable or intubated patients.
These are recommendations developed with the Indian critical care setting in mind. Hospitals must consider their own regulations and clinical requirements.
Prepare equipment and monitoring
Portable monitoring and support systems should match the patient's needs.
Necessary equipment should remain functional during transport.
Coordinate departments
The destination should be prepared before the patient arrives.
Communication and route planning can help reduce avoidable delays.
Document transport and conduct handovers
Structured documentation and communication support continuity between teams.
Checklists may help make important preparation steps more consistent.
Source: ISCCM — Position Statement on Intrahospital Transport, 2025.
A Practical 15-Point Patient Transport Safety Checklist
The following checklist is an educational synthesis of published guidance.
It has not been independently validated as a clinical checklist and should not replace hospital-approved procedures.
Before transport
1. Confirm the clinical indication. Identify the examination, procedure or destination and the reason movement is necessary.
2. Assess patient stability. Review the clinical condition and anticipated support requirements.
3. Confirm destination readiness. Ensure the receiving department can accommodate the patient and provide the necessary services.
4. Assign the transport team. Establish responsibility for clinical care, equipment, movement and communication.
5. Prepare monitoring and support. Check the systems required by the patient's condition.
6. Verify equipment power and supplies. Confirm that necessary resources are suitable for the planned journey.
7. Secure connected devices. Review relevant tubes, drains, catheters and monitoring connections.
8. Inspect the transport surface. Check the appropriate brakes, wheels, side rails, positioning and safe working load.
During transport
9. Maintain appropriate monitoring. Continue the clinical observation required by the patient.
10. Communicate relevant changes. Team members should be able to recognise and escalate concerns.
11. Manage the environment. Consider routes, doors, elevators, turns and congestion.
At the destination
12. Perform a structured handover. Communicate the patient's condition and required ongoing care.
13. Confirm continuity of support. Recheck the equipment and clinical services needed at the destination.
After transport
14. Reassess the patient. Review relevant clinical observations after arrival or return.
15. Document incidents and near misses. Record unexpected events and operational problems according to hospital policy.
The checklist covers more than physical movement.
It includes clinical preparation, communication, technology and follow-up.
A checklist does not guarantee that adverse events will be prevented. Its purpose is to support consistent execution of important tasks.
Do Patient Transport Checklists Actually Improve Safety?
Checklists are commonly recommended, but their impact must be evaluated carefully.
A study published in Australian Critical Care in 2020 examined checklist implementation in a tertiary intensive care unit.
The before-and-after investigation included 76 transports.
Median overall compliance with transport-safety guidance increased from approximately 86.7% to 90%.
Researchers also reported improvements in selected preparation and communication measures.
However, not every indicator improved.
The proportion of transports accompanied by full oxygen cylinders declined after checklist implementation.
This matters because improving an overall compliance score does not guarantee improvement in every relevant safety activity.
The study also did not establish that checklists eliminate serious adverse events.
The strongest direct evidence concerns compliance with defined guidance.
Hospitals should therefore examine both checklist completion and actual safety-related outcomes.
Source: Williams et al. — Intrahospital Transport Checklist, 2020.
How Hospitals Can Measure Their Own Transport Safety
International studies provide important context.
But they cannot determine the precise safety performance of an individual hospital.
For that, organisations need consistent local measurements.
Adverse-event frequency
A useful measure is the percentage of eligible transports during which at least one defined adverse event occurs.
The calculation is:
Transports with at least one defined adverse event ÷ total eligible transports × 100.
Imagine a hospital conducting 200 eligible ICU transports.
If 16 involve at least one event meeting the hospital's definition, the transport-level adverse-event proportion is 8%.
This is a hypothetical example, not an observed safety benchmark.
Hospitals must maintain consistent definitions and avoid double-counting transports with multiple events.
Serious-event frequency
Life-threatening deterioration and other severe outcomes should be measured separately from minor observations.
Severity definitions should remain consistent over time.
Equipment-related incidents
Technical problems can be tracked according to type.
Relevant categories may include monitoring malfunction, equipment disconnection, power problems and other device-related issues.
Near misses and hazards
Recording hazards before harm occurs can help reveal weaknesses in the system.
However, the number of hazards detected may depend on the intensity of observation and reporting practices.
A hospital that identifies more hazards is not necessarily less safe.
Preparation compliance
Hospitals can assess whether required clinical, equipment and communication checks are performed.
Compliance measures describe processes, not direct clinical outcomes.
Delays and destination readiness
Unexpected waiting and receiving-department preparation problems can be examined as operational indicators.
However, shorter transport time does not automatically mean safer transport.
Transport categories
Critical care transport should be analysed separately from routine, lower-acuity movement where appropriate.
Emergency and elective transfers may also require different interpretation.
A useful safety dashboard explains what is happening and why. It should not exist merely to produce one attractive percentage.
An Original 90-Day Hospital Transport Safety Review
Published research suggests a practical approach to local evaluation.
The following 90-day framework is an Optium editorial proposal for organisational quality improvement.
It is not a validated clinical intervention or a guarantee of reduced adverse events.
Days 1–30: Map the existing process
Identify the hospital's main patient transport categories.
Review transport volumes, destinations, clinical teams, equipment and routes.
Document how adverse events, hazards and near misses are currently defined.
Observe selected workflows using appropriate institutional approval and procedures.
The objective is to understand the existing system before introducing changes.
Days 31–60: Identify the main constraints
Review recurring problems in preparation, clinical support, equipment, communication and destination readiness.
Classify the findings consistently.
For example, repeated equipment failures may indicate maintenance or configuration problems.
Recurring destination delays may indicate weaknesses in coordination.
Handling difficulties may reveal a mismatch between the transport surface and the hospital's physical environment.
Priorities should be based on locally observed risks rather than assumptions.
Days 61–90: Test targeted improvements
Select interventions that address the problems identified.
Possible responses include revised procedures, equipment maintenance, role clarification, staff training or workflow redesign.
Monitor the relevant indicators after implementation.
Check for unexpected consequences.
Do not assume an intervention has improved patient safety solely because it has been completed.
After 90 days
Quality improvement should continue.
Hospitals can incorporate transport indicators into routine clinical governance, equipment management and incident review.
The goal is to make transport safety a measurable organisational responsibility.
The most valuable improvement is the one that addresses a documented problem, not the one that introduces the most visible new equipment.
Why Hospital Stretcher Design Still Matters
The research makes one point particularly clear.
Transport safety cannot be solved through equipment selection alone.
But transport equipment is still part of the system.
A stretcher may need to travel through crowded corridors, fit inside elevators, support clinical devices and remain stable during patient handling.
The appropriate configuration depends on the patient and intended workflow.
Optium's comparison of patient trolleys and hospital stretchers explains why defining the journey is more useful than selecting equipment according to a generic product name.
Braking and stability
Transport equipment must move when required and remain stable when stationary.
Brake mechanisms should be reliable, accessible and suitable for the intended use.
They must also be operated correctly.
Steering and manoeuvrability
Castor systems, directional locks and fifth-wheel mechanisms can influence handling.
Hospitals should test these functions on the routes where the equipment will actually be used.
Side rails and patient access
Side rails should provide appropriate support while allowing necessary clinical access.
Their design, locking mechanisms and compatibility with transfer procedures matter.
However, side rails do not eliminate every fall risk.
Optium's research on hospital patient falls and equipment safety explains why bed height, brakes, patient condition and supervision must be considered together.
Height adjustment
Adjustable transport surfaces may support particular patient transfers and caregiver activities.
The appropriate height range depends on the intended application and other surfaces used by the hospital.
Accessory compatibility
Oxygen-cylinder holders, IV poles and monitoring accessories may be relevant in certain environments.
However, the presence of an accessory does not establish that a stretcher is suitable for every critical care transport.
Compatibility should be verified.
Cleaning and maintenance
Transport equipment moves between clinical spaces and is touched repeatedly by different people.
Cleaning procedures must cover relevant surfaces, mechanisms and accessories.
Optium's research on high-touch hospital surfaces and equipment contamination provides useful context for evaluating cleanability.
Department-specific requirements
Emergency, trauma, recovery and routine transport have different needs.
Optium's hospital stretcher buying guide by department explains why clinical use should determine the required functions.
The best stretcher is not automatically the one with the longest specification sheet. It is the one that reliably supports the intended patient journey.
Choosing the Right Stretcher for Different Hospital Transport Scenarios
Optium's stretcher portfolio includes configurations intended for emergency departments, trauma units, recovery environments, routine transport and operating room workflows.
The following comparisons use manufacturer-published specifications.
They are not claims that any specific model has been proven to reduce adverse-event rates.
Emergency transport: EMERGEUM
The Optium EMERGEUM Functional Emergency Stretcher includes hydraulic height adjustment, Trendelenburg and reverse Trendelenburg positioning, and an X-ray-translucent platform with a sliding cassette holder.
Its published configuration also includes 200 mm castors, central braking, steering control, a fifth wheel and an oxygen-cylinder holder.
The stated safe working load is 250 kg.
These features are relevant when assessing emergency and diagnostic transport workflows involving frequent movement, positioning and equipment access.
Trauma and diagnostic workflows: MOMENTUM
The Optium MOMENTUM Functional Trauma Stretcher includes a three-section mattress surface, hydraulic height adjustment and a full-length radiolucent HPL platform.
It also features central and directional braking, with an optional fifth wheel.
The stated safe working load is 250 kg.
Its configuration may be relevant where trauma assessment, patient access and radiographic examination form part of the clinical workflow.
Emergency positioning and movement: AVERON
The Optium AVERON Functional Emergency Stretcher includes hydraulic height adjustment, an X-ray-translucent platform, a sliding cassette holder, central braking and a fifth wheel.
The stated safe working load is 250 kg.
Its suitability should be assessed against the exact emergency department requirements and the equipment needed during patient movement.
Recovery and observation: EPSILON
The Optium EPSILON Functional Recovery Stretcher includes a seven-section mattress surface, hydraulic height adjustment, positioning functions and an X-ray-translucent platform.
The published configuration includes central braking and a fifth wheel.
The stated safe working load is 300 kg.
Recovery environments may prioritise different positioning and support requirements than emergency or trauma units.
The relationship between patient positioning and recovery needs is explored further in Optium's postoperative hospital bed and recovery guide.
Routine patient movement: TRAVELER
The Optium TRAVELER Patient Stretcher includes gas-spring backrest adjustment, Trendelenburg adjustment, collapsible side rails, central-lockable castors and a radiolucent platform.
The stated safe working load is 250 kg.
This configuration provides an option for facilities evaluating internal transport requirements without assuming that every patient journey requires the same emergency stretcher specification.
Hydraulic transport: ST 62
The Optium ST 62 Hydraulic Patient Stretcher includes hydraulic height adjustment, gas-spring backrest positioning and collapsible side rails.
Its published options include central locking, an oxygen holder and an X-ray cassette holder.
The stated safe working load is 220 kg.
Procurement teams should confirm which functions are standard and which depend on the ordered configuration.
Operating room transfers: OT TRANS
The Optium OT TRANS Operating Room Transfer Stretcher uses separate stainless-steel chassis intended for clean and non-clean areas, together with a sliding patient-support platform.
This design addresses a different workflow from ordinary corridor transport.
Operating room transfers must be evaluated alongside the facility's infection-prevention and patient-handling procedures.
What the comparison demonstrates
Emergency, trauma, recovery and routine transport equipment should not automatically be considered interchangeable.
The final decision depends on clinical use, patient characteristics, positioning requirements, safe working load, transport route and equipment compatibility.
Hospitals can explore the full Optium hospital stretcher collection to evaluate the available configurations.
Manufacturer specifications should be verified against the latest technical documentation before purchase.
Seven Procurement Tests Hospitals Should Perform Before Choosing Stretchers
A product specification can describe useful functions.
But it cannot demonstrate how the equipment will behave in a particular hospital.
Healthcare organisations should consider practical evaluation under appropriate supervision.
1. Test the actual transport route
Assess movement through relevant corridors, turns, elevators and doorways.
Observe steering, braking and handling under intended conditions.
2. Test transfer compatibility
Review the relationship between the stretcher and other patient-support surfaces.
Evaluate compatibility with approved handling techniques and equipment.
3. Test equipment accessories
Confirm the suitability of required holders, poles and other accessories.
Consider their positioning during movement.
4. Test clinical accessibility
Healthcare staff should assess whether necessary patient access can be maintained during appropriate procedures.
5. Test cleaning procedures
Environmental services personnel should review frequently touched surfaces, moving mechanisms and accessible cleaning areas.
6. Test maintenance requirements
Biomedical engineering teams should examine inspection procedures, replacement parts, repair access and anticipated service needs.
7. Test the complete workflow
Evaluate how the selected equipment interacts with staffing, monitoring, patient transfers and destination requirements.
Hospitals preparing larger procurement programmes may also consult Optium's 120-item hospital equipment planning checklist to consider the broader equipment environment.
The real test of a transport stretcher is not how it looks in a catalogue. It is how effectively it fits the hospital's actual work.
Ten Common Patient Transport Safety Mistakes
1. Treating transport as a non-clinical activity
Moving a critically ill patient may involve continuing essential treatment and monitoring.
Transport responsibilities must reflect that clinical complexity.
2. Comparing adverse-event rates without checking definitions
Different studies count different outcomes.
Direct comparisons can be misleading without consistent definitions.
3. Assuming installed equipment is operationally ready
A stretcher or monitor may exist but still be unsuitable, unavailable or incorrectly configured for the intended transport.
4. Preparing the transporting team but not the destination
Patient movement requires coordination between departments.
A receiving area that is not ready can create avoidable delays.
5. Ignoring near misses
Hazards that do not cause injury can still reveal weaknesses in equipment, communication or processes.
6. Choosing equipment without testing the environment
A product may meet its technical specifications while creating difficulties in narrow corridors or particular clinical settings.
7. Introducing a checklist without measuring compliance
A documented procedure does not prove that required activities are consistently performed.
8. Measuring only severe incidents
Serious events are important, but examining equipment problems and process hazards can also support improvement.
9. Assuming faster transport always means safer transport
Reducing avoidable delays may be beneficial.
However, speed cannot replace necessary clinical preparation and monitoring.
10. Treating procurement as the entire solution
Equipment selection is one part of a broader safety system involving personnel, clinical procedures, technology and organisational coordination.
What We Know — and What We Still Do Not Know
What the research supports
Intrahospital transport of critically ill patients can involve physiological events, technical problems and other safety hazards.
The 2022 meta-analysis reported a pooled adverse-event frequency of 26.2% across 24 studies.
The 2023 I-TOUCH investigation recorded adverse events during approximately 9.6% of transports.
Life-threatening events were less frequent than broadly defined adverse events in the meta-analysis.
Observational research has identified hazards involving technology, tasks, teams, organisations and the physical environment.
Professional guidance supports structured preparation, appropriate clinical monitoring, trained teams and effective communication.
Checklists can improve compliance with defined transport procedures.
And transport equipment should be selected according to the clinical setting and actual patient journey.
What remains uncertain
The research does not establish that every fourth ICU transport causes injury.
The pooled percentage does not represent one universal adverse-event frequency applicable to every hospital.
Observed complications cannot automatically be attributed solely to the transport process.
The research does not establish that any particular stretcher model reduces adverse events by a specific percentage.
Introducing a checklist does not guarantee that serious incidents will disappear.
And individual hospitals cannot be ranked reliably without considering reporting definitions, patient characteristics and risk adjustment.
These limitations do not weaken the case for improving transport safety. They explain why better measurement and careful interpretation are essential.
Frequently Asked Questions About Intrahospital Patient Transport
What is intrahospital patient transport?
Intrahospital transport is the movement of a patient between locations within the same healthcare facility, such as from an ICU to radiology or from an emergency department to an operating room.
How often do adverse events occur during ICU transport?
A 2022 meta-analysis reported a pooled frequency of 26.2%, while a 2023 multicentre study reported approximately 9.6%.
The studies used different methods and populations, so neither percentage is a universal rate.
Does one in four ICU transfers result in patient harm?
No. The 26.2% figure includes different categories of adverse events. It does not mean that one in four transported patients is injured.
What complications can occur during intrahospital transport?
Published studies report cardiovascular, respiratory and neurological events, as well as equipment problems and communication failures.
The type and frequency depend on patient characteristics and research definitions.
Why are critically ill patients particularly vulnerable?
Some patients depend on continuous monitoring, respiratory support, medication infusions and other essential clinical services.
Transport changes the environment in which those services are delivered.
Who should accompany a critically ill patient?
The appropriate team depends on clinical requirements and institutional procedures.
The 2025 ISCCM guidance recommends at least two team members, including the assigned ICU nurse, with additional qualifications and medical accompaniment according to the patient's needs.
What should hospitals check before transporting an ICU patient?
Relevant areas include clinical assessment, receiving-department readiness, necessary personnel, monitoring, equipment preparation, connected devices and communication.
Institution-approved clinical protocols must guide the process.
Can checklists improve patient transport safety?
Checklists may improve the consistency of preparation and compliance with safety guidance.
However, better compliance does not automatically demonstrate fewer serious adverse events.
What is the difference between a safety hazard and an adverse event?
A hazard is a condition that creates risk.
An adverse event is an undesirable occurrence defined by a reporting framework.
A hazard may be corrected before an adverse event or patient harm occurs.
How can hospitals measure transport safety?
Useful measures include transport-level adverse-event frequency, serious incidents, near misses, equipment problems, destination delays and compliance with defined procedures.
Consistent definitions are essential.
Can a hospital stretcher prevent patient falls?
Appropriate design features may support safer handling, but no stretcher can prevent every fall.
Patient assessment, correct use, supervision and approved transfer procedures remain important.
Does an X-ray-compatible stretcher work inside an MRI scanner?
Not automatically.
MRI compatibility requires a separate safety assessment. X-ray compatibility alone does not establish that a device is safe in an MRI environment.
Does a fifth wheel make a stretcher safer?
A fifth wheel may support manoeuvrability and directional control in certain environments.
Its actual benefit depends on the stretcher design, hospital routes and correct operation.
Should every hospital purchase advanced emergency stretchers?
No.
Different departments have different transport requirements.
The appropriate configuration should be selected according to patient needs, clinical workflows and technical requirements.
The Most Important Part of an ICU Transfer Is Not the Distance
A hospital transfer may cover only a few hundred metres.
A patient may travel from an intensive care unit to a nearby imaging department.
The corridor is familiar.
The elevator is close.
The journey appears routine.
But for a critically ill patient, transport means maintaining complex clinical support while the environment changes.
The review covering 12,313 transports demonstrates why adverse events deserve attention.
The I-TOUCH study demonstrates why reported event frequencies can vary substantially.
The observational hazards research reveals that safety depends on much more than physiological monitoring.
And the 2025 professional guidance highlights the importance of preparation, appropriate personnel, equipment and communication.
For hospital administrators, critical care teams and procurement professionals, the conclusion is clear.
Patient transport safety is not simply a stretcher-selection problem.
It requires a coordinated system.
A system that assesses the patient before departure.
Prepares the necessary personnel and equipment.
Maintains appropriate care during movement.
Coordinates the destination.
Recognises and responds to problems.
And learns from incidents and near misses.
The safest hospital transfer is not necessarily the shortest or fastest journey. It is the journey in which essential care is maintained, foreseeable hazards are addressed and the patient reaches the destination with appropriate clinical support.
Research Methodology and Editorial Transparency
Research reviewed: October 2026.
This article is an editorial synthesis of published clinical research, professional recommendations and manufacturer-reported equipment specifications.
It does not constitute a new clinical trial, an independent patient-level investigation or a validated transport-safety protocol.
Interpretation of the headline statistic
The 26.2% pooled adverse-event frequency comes from the 2022 meta-analysis by Murata and colleagues.
The review included 24 studies, 12,313 transports and 1,898 critically ill patients.
Its 95% confidence interval was 15.0% to 39.2%, with exceptionally high heterogeneity.
The result should not be interpreted as a universal probability of patient injury.
Comparative research
The I-TOUCH study was published in 2023 and analysed 1,065 transport episodes involving 893 patients.
Adverse events occurred during 102 transports.
The Bergman study identified 365 hazards during 51 transports in 2017.
The Williams study evaluated checklist implementation across 76 transports.
These investigations measured different outcomes and should not be combined without an appropriate statistical method.
Original editorial contributions
This article presents an educational 15-point transport checklist, an operational measurement approach and a proposed 90-day safety-review framework.
These are editorial syntheses based on published evidence.
They have not undergone independent clinical validation.
Product information
Optium stretcher features described in this article are based on manufacturer-published specifications.
They are not evidence of product-specific reductions in clinical complications or patient harm.
All equipment should be assessed for intended use, applicable technical requirements and institutional clinical procedures.
Primary Research Sources
1. Murata et al. — Adverse Events During Intrahospital Transport of Critically Ill Patients: A Systematic Review and Meta-analysis
American Journal of Emergency Medicine, 2022.
https://doi.org/10.1016/j.ajem.2021.11.021
2. Zirpe et al. — Adverse Events During Intrahospital Transport of Critically Ill Patients: I-TOUCH Study
Indian Journal of Critical Care Medicine, 2023.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10504651/
3. Bergman et al. — Safety Hazards During Intrahospital Transport: A Prospective Observational Study
Critical Care Medicine, 2017.
https://pubmed.ncbi.nlm.nih.gov/28787292/
4. Indian Society of Critical Care Medicine — Position Statement on Intrahospital Transport of Critically Ill Patients
Indian Journal of Critical Care Medicine, 2025.
https://doi.org/10.5005/jp-journals-10071-24939
5. Williams et al. — A Checklist for Intrahospital Transport of Critically Ill Patients Improves Compliance With Transportation Safety Guidelines
Australian Critical Care, 2020.
https://doi.org/10.1016/j.aucc.2019.02.004
6. Anesthesia Patient Safety Foundation — Intrahospital Patient Transport: Checklists, Adverse Events, and Other Considerations
February 2025.
7. Agency for Healthcare Research and Quality — Adverse Event During Intrahospital Transport
Patient Safety Network.
https://psnet.ahrq.gov/web-mm/adverse-event-during-intrahospital-transport