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Workforce Survey of Pediatric Interfacility Transport Systems in the United States
Justinn Tanem1, David Triscari, Melina Chan
1From the *Medical College of Wisconsin, Milwaukee, WI; and †University of Arkansas for Medical Sciences, Little Rock, AR.
Insights
Pediatric interfacility transport teams are predominantly registered nurse-respiratory therapist combinations. While quality assurance is common, team composition and training for these critical pediatric transports remain poorly characterized.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Healthcare Workforce Studies
Background:
- Interfacility transport of pediatric patients demands specialized skills.
- Current knowledge regarding pediatric transport teams, including their models, configurations, training, and quality assurance, is limited.
Purpose of the Study:
- To characterize the current state of pediatric interfacility transport in the U.S.
- To identify predominant team models and configurations.
- To assess team training standards and quality assurance practices.
Main Methods:
- A descriptive and qualitative web-based survey was developed.
- Potential pediatric transport teams were identified.
- One survey was completed per team.
Main Results:
- 111 responses were recorded from 179 identified teams (62% response rate).
- Dedicated teams (77%) were more common than unit-based teams (16%).
- Registered nurses (98%) and respiratory therapists (66%) were primary team members; physicians were rarely utilized (<5%).
- Registered nurse-respiratory therapist was the most frequent team composition (30%).
- Over 55% of teams performed <500 pediatric transports annually.
- Quality assurance activities were reported by 96% of teams.
Conclusions:
- Pediatric interfacility transport team composition and training are complex and not well-understood.
- Variations in organizational models, team makeup, and training requirements have not been previously documented.
- Findings will inform the development of future pediatric transport team standards and improvements.
Objectives:
The interfacility transport of pediatric patients requires a highly skilled and well-trained workforce, of which little is known. The primary study purpose was to characterize the current state of pediatric interfacility transport in the United States including, but not limited to, which team models predominate, what team configurations are used, team training standards, and the use of quality assurance metrics.
Methods:
A descriptive and qualitative Web-based survey questionnaire was developed. Potential participants were identified, and 1 survey was completed per team.
Results:
In total, 179 teams with pediatric transport capabilities were identified, and 111 responses were recorded (response rate, 62%), of which dedicated teams comprised 77% and unit-based teams comprised 16%. Over 98% reported using a registered nurse as a team member, in comparison to 66% for respiratory therapists and 42% for paramedics. Less than 5% reported utilizing an associate level provider or physician for pediatric transports. The most common team composition was a registered nurse-respiratory therapist combination (30%). Over 55% of the respondents reported performing less than 500 pediatric transports per year. Quality assurance activities were performed by 96% of the respondents.
Conclusions:
The team composition and training for interfacility transport of pediatric patients is a complex and not well-characterized process; furthermore, the varying organizational models, team composition, and training requirements for teams have not been previously reported. These results will aid in the future development of team standards for pediatric transport and help guide further improvements in this field.
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