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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Effect of a centralised transfer service on characteristics of inter-hospital neonatal transfers
S T Kempley1, Y Baki, G Hayter
1Barts and the London, NHS Trust, London, UK. steve.kempley@bartsandthelondon.nhs.uk
Objective:
To determine the effect of a centralised neonatal transfer service on numbers of neonatal transfers and the time taken for teams to reach the baby.
Design:
Prospective census of neonatal inter-hospital transfers between May and July 2004. Comparison with a previous census undertaken before introduction of the service. Analysis of requests for antenatal in-utero transfer to the regional emergency bed service.
Setting:
Geographically defined area in London and southeast England.
Patients:
Babies transferred to or from a neonatal unit.
Interventions:
Introduction of a centralised neonatal transfer service.
Main Outcome Measures:
Numbers of transfers, time taken for teams to arrive to the baby (response time).
Results:
During the census there were 835 transfers with an increase of 34% from the previous census (n = 619). Most of the increase was in urgent transfers for neonatal intensive care. There was a mean of 4.4 urgent transfers a day, with 3.9 elective and 0.8 short-term transfers. Over the same period in-utero transfers decreased. Response times improved from a median of 2 h in 2001 to 1.45 h in 2004 (p<0.05). The 90th centile fell from 6 h to 4.9 h.
Conclusion:
Following the introduction of a centralised neonatal transfer service, response times improved significantly. An increase in the numbers of transfers for medical intensive care was associated with a reduced number of in-utero transfers. To balance the improved safety and accessibility of neonatal transfer, similar developments may be needed to facilitate in-utero transfer.
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