Inter-hospital transport of critically ill children

Area of Science:

• Pediatric critical care
• Healthcare systems analysis
• Patient transport logistics

Background:

• Paediatric tertiary care in Ireland is highly centralized in Dublin.
• Children are frequently transferred from regional units to Dublin for specialized care.
• Current transfer processes may not meet the needs of critically ill children.

Purpose of the Study:

• To quantify and describe inter-hospital transfers of pediatric patients from a regional tertiary hospital over two years.
• To identify challenges and gaps in the existing pediatric transfer system.
• To advocate for improvements in critical care transport services for children in Ireland.

Main Methods:

• Retrospective review of 73 pediatric patient transfers over a two-year period.
• Analysis of transfer destinations, required level of care (intensive care, neonatal care), and adherence to national transfer team criteria.
• Assessment of documentation quality and timing of transfers.

Main Results:

• 94.5% of transfers were to the main Dublin tertiary center.
• 20.5% of transfers required intensive care.
• Only 23.5% of critically ill neonates met criteria for and had availability of the National Neonatal Transfer Team (NNTT).
• Significant events were poorly documented (3/73 cases).
• Most transfers occurred outside standard working hours.
• Documentation standards were highly inconsistent.

Conclusions:

• The current system for transferring critically ill children in Ireland is inadequate.
• There is a critical need for a dedicated national transport service for critically ill children.
• Improvements in documentation, timing, and specialized team availability are essential for patient safety.