Transport determinants for continuing care residents assessed by an EMS urgent response team: A retrospective observational study

Abstract

Introduction: Alberta Health Services (AHS) Emergency Medical Services (EMS) in the City of Edmonton recently introduced an "EMS Continuing Care Urgent Response Team" (ECCURT) to support continuing care residents by providing urgent care on-site, thereby minimizing unnecessary patient transfers to emergency departments. ECCURT is comprised of Advanced Care Paramedics and Nurse Practitioners, and is dispatched via a dedicated consult line and/or 911. Objectives: This study will identify various patient characteristics that are correlated with frequency of transport to hospital. Methods: This six-month retrospective, observational study of patient data includes all new patients assessed between January 1, 2016 and June 30, 2016. Multiple regression analysis was performed to determine whether a statistically significant correlation exists comparing age, Goals of Care Designation (GCD), and Canadian Triage Acuity Scale (CTAS) score, with transport frequency.Results: Four hundred and seventy-one (83%) of 567 new patients assessed by ECCURT during the study period had established GCDs in place. Five hundred and twenty-one (92%) of our patients had a CTAS score assigned.One hundred and thirty-one (23%) of our patients were transported to hospital. All patients with a GCD of C2 were managed by our team on-site. Multiple regression analysis reveals a statistically significant correlation of age, GCD, and CTAS score with frequency of transport to hospital (F statistic = 3.26 E-11). P-values for each variable are: age = 0.92; GCD = 0.05; CTAS = 5.08 E-12. Conclusion:Although patient age is not strongly correlated with transport frequency independently, GCD and CTAS score may be quite useful predictors for Community Care EMS Teams when selecting patients who can be managed on-site without transport to hospital.