Variations in Interfacility Transport: Approach to Call Intake, Team Composition, and Mode of Transport

Impact of interhospital transfer on patients with Alzheimer's disease and other related dementias

“…Rather, it occurs at the discretion of the receiving physician and upon approval by an accepting physician after a telephone discussion regarding the needs of the patient and the potential of the receiving hospital to meet those needs. Willingness of a receiving specialist to accept transfer of a patient varies widely by institution, speciality, and individual, as do patient outcomes after transfer 12–14 …”

“…Willingness of a receiving specialist to accept transfer of a patient varies widely by institution, speciality, and individual, as do patient outcomes after transfer. [12][13][14] Patients living with Alzheimer's disease and related dementias (ADRD) visit the ED an average of 1.5 times per year, surpassing the number of visits for patients with cancer, ischemic heart disease, or heart failure. 15,16 They are particularly vulnerable to poor outcomes after any care transition, including interhospital transfer, because of medication errors, environmental changes that can negatively impact cognition, and the physical transition itself.…”

Can a single primary care paramedic configuration safely transport low-acuity patients in air ambulances?

“…1 Most land and air ambulance programs in Canada require a two-person medical crew, and their regulations are based on literature suggesting that the dual provider configuration is safer. [2][3][4][5][6][7][8][9][10][11][12][13] In general, however, the evidence for these recommendations is not extensive and somewhat dated. Moreover, one challenge of the method presented in existing literature is the heterogeneity of the types of providers studied (paramedics v. nurses v. physicians).…”

“…Moreover, one challenge of the method presented in existing literature is the heterogeneity of the types of providers studied (paramedics v. nurses v. physicians). [2][3][4][5][6][7][8][9][10][11][12][13] Another major limitation is that patient safety was not explicitly defined or measured in these studies. The World Health Organization (WHO) Patient Safety Curriculum defines patient safety as "the reduction of risk of unnecessary harm associated with health care to an acceptable minimum."…”