O2102: Development of Neonatal and Pediatric Mode of Transport Tool: A Scoring Algorithm to Guide Dispatch

Purpose/Objectives:

Objective: Standardization of a Mode of Transport (MOT) tool to create consistent dispatch of a neonatal and pediatric transport team into a tertiary care center.

Background: We are a neonatal and pediatric interfacility transport team that facilitates patient transportation via ambulance or rotor-wing. We operate out of a level 1 Pediatric Trauma Center with a level IV Neonatal ICU in the Midwest. Prior to January 2020, incoming calls for patient transport were received by transport nurses who were actively involved in transporting the patients. To standardize care, the transport nurses became dedicated to the Access Center (AC) or transport team. In March of 2020 the AC was utilizing critical care nurses with no previous patient transport experience. During that transition period, the AC utilized a generalized dispatch tool for both neonatal and pediatric patients. The use of a generic tool created challenges for nurses without transport experience to determine the best MOT (ambulance versus rotor-wing). MOT was further complicated by the transport team’s use of out-of-hospital bases, located 120 miles off the main hospital campus. While these bases allow for quicker access to rural hospitals, it becomes challenging when considering the fastest and most appropriate MOT. The need for a tool that would ease decision making was imminent and a team was set to work.

Design/Methods: Method: A sub-committee was created to assess the current MOT tool. The GAMMA database was utilized, and dispatch tools used by other transport teams were reviewed. Using the ABCDE (age, breathing, circulation, disability, distance, critical diagnosis) model, as well as contributing factors such as hospital capabilities, traffic, and team availability, two separate algorithms were developed: one for neonatal, and the other for pediatric patients. Expert consultation with the medical directors was done and revisions to the algorithms made. Additionally, previous patient transport data were culled to compare the MOT with the updated scoring algorithm; the updated algorithm was used with patient scenarios and staff were educated on the revised scoring algorithms with opportunity to practice.

Results:

Results: Two dispatch tools were created from one tool that served two distinct patient populations. The tools enhanced and improved patient throughput with efficient decision making. This innovation during a pandemic period created a robust and safe system for patient transportation, the first of its kind in the region. The tool had an added benefit of increasing satisfaction and collaboration amongst team members and improved cost of healthcare due to effective MOT decisions.

Conclusion/Discussion:

Conclusion: The creation and utilization of two tools to determine MOT in the dispatch process for neonatal and pediatric patients provided standardization and facilitated workflow.