Safely Transferring the Critically Ill Patient out of Your Emergency Department.

Regionalized systems of care increasingly rely on critical care transport (CCT) to move high-acuity patients to centers with specialized resources. This article outlines the complex clinical, operational, and ethical considerations that shape interfacility transport, emphasizing the need for deliberate risk-benefit assessment, patient optimization, and clear communication among sending clinicians, transport teams, and receiving facilities. Variability in CCT team training, capabilities, and staffing models requires clinicians to understand regional resources. By applying systems-based thinking and the "right patient, right time, right team, right place" framework, clinicians can ensure safe, equitable, high-quality transport within regionalized care networks.