Interfacility Transfer Teams: A Pilot Study to Assess Viability as a Skill Sustainment Platform

Area of Science:

• Emergency Medicine
• Military Health
• Patient Safety

Background:

• A US Naval hospital established interfacility transfer (IFT) teams using active duty personnel due to high patient acuity and limited local resources.
• Improvements in training and quality assurance were implemented in 2017.
• En route care (ERC) is a critical capability gap within the US Navy, necessitating skilled clinicians.

Purpose of the Study:

• To assess patient safety during interfacility transfers conducted by locally sourced and trained IFT teams.
• To evaluate the effectiveness of IFT programs as a skill sustainment platform for ERC clinicians.

Main Methods:

• A retrospective review of 1,193 patient care reports from a quality assurance database.
• Data collected included patient demographics, level of care, reason for transport, and interventions provided.
• Analysis focused on appropriateness of patient management and skill sustainment for active duty personnel.

Main Results:

• Interventions were required for 10.7% of patients, with 4.9% needing ventilator management.
• Medical deterioration occurred during 1.8% of transports, and 90.9% of these events were managed appropriately.
• No patient harm was reported as a direct result of the transport.

Conclusions:

• Locally trained IFT teams can safely transport critically ill patients without adverse outcomes.
• IFT patient care encompassed routine interventions, ventilator management, and management of patient deterioration.
• IFT programs show potential as a viable skill sustainment platform for en route care clinicians.