Adequacy of care during interfacility transfer in Taiwan: A pilot study

Huang, Shao-Peng; Lin, Yu-Yuan; Kuo, Yuh-Shin; Huang, Yu‐Fen; Wu, Shu-Chun; Huang, Kuo-Tien; Lu, Chien-Hsin; Chiu, Po‐Wei; Lin, I-Chen; Chang, Ying-Hsin; Chin, Chao-Wei; Chang, Hung-Chieh; Lin, Chih‐Hao

doi:10.1016/j.jfma.2022.03.018

Cited by 2 publications

(8 citation statements)

References 35 publications

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“…This result implied that most patients with type A AD received inadequate hemodynamic management at the transferring hospital. From the perspective of transfer safety [16,18,21], inadequate hemodynamic management before transfer could have adverse effects on inter-facility safety, such as accelerating the progression of type A AD due to persistently uncontrolled SBP and HR [12]. The transfer staff should request the transferring hospital to provide better hemodynamic management before transfer [16].…”

Section: Discussionmentioning

confidence: 99%

“…Performing routine intubation before transferring to target hospital is not always necessary [13,23], but for the sake of patient safety, when there is a possibility of respiratory failure, ambulance staff should be equipped with the ability to manage it immediately [12]. In other words, the level of staff in the ambulance participated in the transfer should have protocol to be followed to ensure patients' transfer safety [16]. We recommend one physician, and one nurse should participate the transfer of type A AD [24].…”

Section: Discussionmentioning

confidence: 99%

“…In Taiwan, nurses can adjust the dose of medication under the guidance of a set-up protocol or order, but EMTs are not allowed to do so. We suggest medical directors in the transfer network should establish protocols of transfer safety, especially in critical illness [12,16]. (type A AD, active upper gastrointestinal bleeding, intracranial hemorrhage, acute coronary disease...etc.)…”

Section: Discussionmentioning

confidence: 99%

“…(type A AD, active upper gastrointestinal bleeding, intracranial hemorrhage, acute coronary disease...etc.) Besides, we should pay more attention to transfer safety through establishing ambulance regulations by relevant department (fire department or health authority) and promoting education course about transfer safety in staff (EMT, nurse and physician) might participate in the transfer [16,20,27].…”

Section: Discussionmentioning

confidence: 99%

“…While a limited number of studies [12,16] have explored the safety of inter-facility transfers for patients with type A AD, it is crucial to prioritize these transfers to enhance the quality of care and the chances of survival. Therefore, this study aims to assess the quality of care provided to patients with type A AD who undergo inter-facility transfers at a single medical center in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

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Quality of inter-facility transfer for Type A aortic dissection patients in a medical center in Taiwan: a retrospective observational study

2024

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Inter-facility transfer of patients with type A aortic dissection (AD) requires timely and efficient medical care. However, the quality of care provided during the transfer remains largely unknown. This study aimed to evaluate the quality of care of patients with type A AD who underwent inter-facility transfer at a single medical center in Taiwan. This retrospective cohort study enrolled all patients with type A AD who underwent inter-facility transfer between January 2017 and December 2019. Patients with complete transfer records and electronic medical charts in the emergency department (ED) were included. Patients who experienced a cardiac arrest episode before transfer were excluded due to poor outcomes. Patients were divided into two groups based on their hemodynamic status: the ideal group with values within the desirable range heart rate (HR) <60 bpm and systolic blood pressure (SBP): 100–120 mmHg and the control group with values out of range (HR >60 bpm or SBP <100 or >120 mmHg) before the transfer. We conducted an analysis of variations of hemodynamic status after the transfer. Among the 378 patients transferred with type A AD, 36 (31.9%) in the ideal group and 255 (96.2%) in the control group experienced hemodynamic deterioration after the transfer. In the ideal group and control group, the presence of nurses and emergency physicians assisting in the transfer accounted for only 6.2% and 7.95%, respectively. The ideal group had a significantly better survival outcome (adjusted OR (aOR): 1.25, 95%confidence interval (CI): 1.12–2.45) compared to the control group. The quality of inter-facility transfer in patients with type A AD is inadequate. Hemodynamic deterioration should be managed by ambulance crews during the transfer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality of inter-facility transfer for Type A aortic dissection patients in a medical center in Taiwan: a retrospective observational study

2024

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A Systematic Review of Route Optimization for Ambulance Routing Problem

Lakshmi¹,

Sekhar²,

Joseph³

et al. 2023

Advances in Health Sciences Research

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Ambulance Routing Problem (ARP) is the part of Emergency Medical Services (EMS), which provide timely medical help for those who are in need. In Medical emergency situation, the key concern is, to provide early treatment. Relocating patients quickly to neighboring medical facilities is extremely difficult given the existing traffic situation and has to be rectified. A lack of EMS owing to urbanization and several routing considerations such as the precise location of the request, traffic problems, road width, and ambulance locations are few of the difficulties. This paper summarizes a number of recent studies on ARP in routing and the issues they raised. In this survey, Routing for Ambulance vehicles is categorized as initiating ambulance from depot to injured location (response Time) and routing from injured location to nearby medical Centre (Travel Time). And, we highlighted challenging issues and constraints related to route optimization in both above mentioned category. Also emphasized the less explored research area like Interfacility hospital transfer and importance of incorporating safety metrics during Ambulance Routing.

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Adequacy of care during interfacility transfer in Taiwan: A pilot study

Cited by 2 publications

References 35 publications

Quality of inter-facility transfer for Type A aortic dissection patients in a medical center in Taiwan: a retrospective observational study

Quality of inter-facility transfer for Type A aortic dissection patients in a medical center in Taiwan: a retrospective observational study

A Systematic Review of Route Optimization for Ambulance Routing Problem

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