Non-ambulance vehicle Interfacility transport (NAVIT) was not associated with adverse patient outcomes

Patients are frequently transferred between hospitals to receive higher levels of care and specialty services. Emergency medical service (EMS) interfacility transfers can often have lengthy wait times and be associated with significant costs to patients. Therefore, some patients are transferred via non-ambulance vehicle. There is a paucity of current literature studying the safety of Non-Ambulance Vehicle Interfacility Transport (NAVIT), and published data consists mostly of anecdotal evidence and case reports. The objective of this study was to determine the prevalence of adverse patient outcomes during or immediately after NAVIT within a single health system.

A retrospective chart review of a single major health system was performed. Charts were obtained via query of this health system's safety reporting database from December 2020 through April 2024. Information obtained from the charts included demographics, vital signs, Glascow Coma Scale, health insurance status, reasons for interfacility transport, reasons for not utilizing EMS transport, and complications during transport. This information was evaluated before and after NAVIT to identify potential decline in patient status. Additionally, hospital course at the receiving hospital was reviewed for decompensation or harm during interfacility transport.

Twenty-seven NAVIT cases were identified between hospitals within the health system. Patients were 48 % were female, 48 % male, and 4 % non-binary, 96 % white, and 4 % African American with a median age of 56 years (range 2-86 years old). Insurance status comprised 15 % Medicaid, 37 % Medicare, and 44 % private insurance with no insurance listed for the remaining 4 %. Reasons for requesting NAVIT included EMS wait times, financial concerns, patient preference, and convenience. All NAVIT patients were stable at the time of departure from the sending hospital. There were no cases of patient decompensation during transport or adverse outcomes during the period studied.

NAVIT was a safe modality of transporting that was not associated with adverse patient outcomes in a small, clinically stable patient cohort at a single health system. Further prospective and multicenter study could help determine the safety of NAVIT across a range of practice settings.