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The cost of family-oriented communication before air medical interfacility transport
A J Macnab1, F Gagnon, S George
1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia. amzcnab@cw.bc.ca
Insights
Family-oriented communication during pediatric air transport significantly reduces parental stress. While extended visits incur minimal costs (approx. $13/patient), transport teams should manage time to avoid overtime and aircraft delays.
Area of Science:
- Pediatric critical care transport
- Healthcare communication strategies
Background:
- Family-centered care is crucial for pediatric patients undergoing interfacility transport.
- Transport teams can mitigate parental stress through direct communication.
- This study assesses the time and cost implications of family-oriented visits during air medical transport.
Purpose of the Study:
- To quantify the duration of family-oriented communication during pediatric air transport.
- To determine the associated costs of these family visits.
- To evaluate the cost-benefit of family-oriented communication in this context.
Main Methods:
- Prospective, double-blind data collection integrated into a larger study.
- Inclusion criteria: infants/children requiring mechanical ventilation and air transport.
- Recorded time from stabilization to departure, noting reasons for delays; calculated costs for overtime and aircraft wait time.
Main Results:
- Forty-six patients were enrolled; 35% experienced delays exceeding 20 minutes due to family visits.
- Nine visits incurred paramedic overtime costs, and two incurred aircraft wait time costs.
- Total cost for visits over 10 minutes was $607, averaging approximately $13 per patient.
Conclusions:
- The financial costs associated with family-oriented communication visits are minimal relative to their benefits.
- Transport teams must remain aware of potential additional expenses like overtime and aircraft delays.
- Balancing communication needs with operational efficiency is key in pediatric air medical services.
Introduction:
Family-oriented communication with parents by transport teams eases the stress associated with transferring children to tertiary care. This study was conducted to determine the duration of family-oriented visits and whether the visit contributed significant cost to the mission.
Method:
Data collection was prospective and double-blind; questions were incorporated into another study. Subjects were infants or children requiring assisted ventilation and air transport to tertiary care. Time from completion of stabilization to departure and reasons for any delay were recorded. Cost of contact time longer than 20 minutes (total acceptable time for family visit and transfer to vehicle) was calculated at paramedic overtime at $0.82/minute and aircraft wait time at $200/hour if incurred.
Results:
Forty-six patients were enrolled. In 16 cases (35%), time between completing stabilization and hospital departure exceeded 20 minutes, with "family visit" listed as the explanation. Nine of these visits incurred overtime, and two incurred aircraft wait costs. Total costs for providing communication visits more than 10 minutes long were $607 or approximately $13 per patient.
Conclusion:
The costs for visit time longer than 10 minutes are small compared with the documented benefits of family-oriented communication. However, transport personnel must be mindful of the potential to incur additional cost through overtime, aircraft wait time, or pilot replacement.