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Response Time in the Transport of Pediatric Patients to a Tertiary Critical Care Unit
Sindy Villacrés1, Chhavi Katyal2, James Gomez3
1Division of Critical Care, Department of Pediatrics, Nemours Children's Hospital, Orlando, Fl.
Insights
Implementing a quality improvement initiative significantly reduced interhospital patient transfer times. The specialized transport team
Area of Science:
- Critical care medicine
- Healthcare quality improvement
- Emergency medical services
Background:
- Interhospital patient transfers to critical care units face significant delays.
- Existing transport protocols often present barriers to timely patient movement.
Purpose of the Study:
- To decrease the time from initial transfer call to specialized transport team arrival.
- To reduce transfer times from 150 minutes to under 40 minutes over two years.
Main Methods:
- A quality improvement initiative monitored transport times for 245 patients over 31 months.
- Interventions included a central transport information line, a specialized pediatric transport team, and a training program.
- Statistical process control charts were used to monitor response times.
Main Results:
- A 76% decrease in transfer time was observed, reducing it from 150 minutes to 36 minutes.
- The process demonstrated stability and effectiveness within 3 months post-intervention.
- Significant reduction in the overall time course of patient transport was achieved.
Conclusions:
- Improved transport services with enhanced resources and personnel increase interinstitutional patient transport efficiency.
- Quality improvement methods are effective in optimizing critical care patient logistics.
Introduction:
Various barriers delay the process of patient transfer to critical care units. We implemented quality improvement methods to decrease the time required for interhospital transfer of critical care patients. As a result, we aimed to decrease the time from initial transfer call to specialized transport team arrival at the referring hospital from 150 minutes to <40 minutes over 2 years.
Methods:
Quality improvement initiative monitoring the length of transport time of 245 patients transferred from referral hospitals to a tertiary pediatric intensive care unit for 31 months from March 2013 to October 2015. We reviewed preexisting transport protocols and identified barriers to the timely arrival to the pediatric intensive care unit. We implemented 3 interventions: a transport information line serving as a central communication center to coordinate the transport process between all stakeholders, the formation of a specialized pediatric transport team, and a training program. We collected transport response time data and monitored the impact of interventions via statistical process control charts.
Results:
There was a significant decrease in the length of the time course pre- and postintervention. We noted a special cause to decrease in time from referral hospital call to arrival of our transport team by 76% from 150 minutes to 36 minutes. In addition, the statistical process chart revealed a stable and effective process without significant shifts above the process mean as early as 3 months postintervention.
Conclusions:
By improving our transport services with additional resources and people, we have improved the efficiency of patient transport between institutions.
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