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Assessment of patient safety during interfacility transport
Patricia Corniero1, Mònica Girona-Alarcón2, Carme Alejandre1
1Servicio de Emergencias Médicas Pediátricas, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat, Barcelona, Spain; Grupo de Investigación de Disfunción Inmunológica y Respiratoria en el Niño Crítico, Institut de Recerca Hospital Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Grupo de Estabilización y Transporte del Niño y Neonato Crítico de la Sociedad Española de Cuidados Intensivos Pediátricos (SECIP), Spain.
Insights
Implementing safety measures significantly reduced adverse events during pediatric interhospital transport. Family presence in ambulances did not increase incidents, improving overall patient care quality and safety.
Area of Science:
- Pediatric critical care medicine
- Patient safety research
- Transport medicine
Background:
- Interhospital transport of critically ill children carries risks of adverse events (AEs) and incidents.
- These events can negatively impact patient outcomes.
- Assessing transport safety and identifying contributing factors is crucial for improving care.
Purpose of the Study:
- To identify adverse events and incidents during pediatric interhospital transport.
- To evaluate the impact of implemented safety measures on transport-related incidents.
- To analyze the association between family presence during transport and incident occurrence.
Main Methods:
- Prospective, observational study design.
- Inclusion of pediatric patients transferred by a specialized transport team.
- Comparison of incidents across two periods (pre- and post-safety measure implementation) and analysis of family presence.
Main Results:
- A total of 1369 transports were analyzed, with 20.7% experiencing incidents.
- A significant reduction in incidents was observed in the second period (12.0%) compared to the first (29.2%), particularly clinical incidents (5.1% vs 20.3%).
- Increased family presence in the ambulance (82.6% vs 76.0%) was not associated with a higher incident rate.
Conclusions:
- Pediatric interhospital transport by specialized, safety-trained teams results in minimal incidents.
- Implementation of patient safety measures effectively reduces transport-related incidents.
- Enhancing safety protocols optimizes care quality for critically ill pediatric patients during transport.
Objective:
The transport of critically ill pediatric patients is associated with the occurrence of adverse events (AE) and incidents that worsen patient outcomes. The primary objective was to determine the AEs and incidents that occurred during interhospital transport and to analyze changes after the implementation of safety measures. The secondary objective was to analyze the association between the presence of family accompanying the patient in the ambulance and the number of incidents.
Material And Methods:
Prospective and observational study, including patients transferred by a specialized pediatric transport team during two periods: period 1 (2017-2018) and period 2 (2022-2023). We compared incidents in the two periods after the implementation of safety measures. We also compared the presence of parents during the transport and its association with the occurrence of incidents.
Results:
We analyzed 1369 transports. A total of 273 (20.7%) patients experienced some incident during transport, with a lower percentage in period 2 (29.2% vs 12.0%; P < .001), especially in patients with clinical incidents (20.3% vs 5.1%; P < .001). Incidents involving a lack of devices or supplies were least frequent, with no differences between the two periods. Family accompanied the patient in the ambulance more frequently in the second period (76.0% vs 82.6%; P = .001), a finding that was not associated with an increase in incidents, with a higher percentage of transports with parents in the care cabin.
Conclusions:
Interhospital pediatric transport performed by teams trained in clinical safety leads to few incidents. Implementing measures to improve patient safety can reduce the frequency of these incidents and optimize care quality.
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