Structured Referral Call Handling Process Improves Neonatal Transport Dispatch Times

Khorshid Mohammad; Soumya Thomas; Chacko J Joseph; Chelsea O'Keef; Leah Leswick; John Montpetit; Elsa Fiedrich; Bryan Rombough; Sumesh Thomas

doi:10.1055/s-0043-1771016

Structured Referral Call Handling Process Improves Neonatal Transport Dispatch Times

Am J Perinatol. 2023 Jul 10. doi: 10.1055/s-0043-1771016. Online ahead of print.

Authors

Khorshid Mohammad¹, Soumya Thomas², Chacko J Joseph², Chelsea O'Keef³, Leah Leswick³, John Montpetit⁴, Elsa Fiedrich¹, Bryan Rombough⁵, Sumesh Thomas¹

Affiliations

¹ Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
² Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
³ Division of Neonatology, Foothills Medical Centre, Calgary, Alberta, Canada.
⁴ Alberta Health Service, Referral, Access, Advice, Placement, Information and Destination (RAAPID), Emergency Medical Services Stonegate Building, Calgary, Alberta, Canada.
⁵ Alberta Health Service, Southern Alberta Neonatal Transport Service, Foothills Medical Centre, Calgary, Alberta, Canada.

PMID: 37429321
DOI: 10.1055/s-0043-1771016

Abstract

Objective: In 2019 the Southern Alberta Neonatal Transport Service adopted a transport call handling process change to expedite transport team mobilization. This study compares the impact of this change on neonatal transport decision to dispatch and mobilization times.

Study design: This retrospective cohort study was conducted using a historical cohort of neonates referred for transportation between January 2017 and December 2021. The "dispatch time" (DT) was the time from the start of consultation to the time a decision to dispatch the transport team was made, whereas "mobilization time" (MT) referred to the time from start of consultation to the time the team departed the home base. In 2019, a DT target of <3 minutes was implemented to meet a target MT of <15 and <30 minutes for emergent and urgent high-risk transport referral calls, respectively. In 2021 use of the "Situation" component of the SBAR (Situation, Background, Assessment, Recommendation) communication tool was introduced with the transport team asking five questions to determine need for mobilization. Data between 2017 and 2018 represented the preintervention period, 2019, the "washout" period for implementation, and 2020 to 2021, the postintervention period. Data were analyzed to determine trends in DT and MT.

Results: The DT was reduced from a median of 5 to 3 minutes following intervention (p < 0.001). DT target goal of 3 minutes was achieved in 67.08% of calls compared with 26.24% in the preintervention period, (p < 0.001). The team achieved MT target goals in 42.71% of urgent and emergent transfers compared with 18.05% prior to intervention (p < 0.001).

Conclusion: Introduction of a time-sensitive referral call handling process improved dispatch and mobilization time of the neonatal transport team.

Key points: · Time-sensitive triaging of neonatal transport referrals improves dispatch and mobilization time.. · A structured referral call handling process improves the efficiency of neonatal transport decision-making.. · Dedicated neonatal transport vehicles are likely to improve neonatal transport mobilization time..