Background: Communication between medical control and critical care transport teams (CCTT) is often complicated by the need to simultaneously tend to the patient’s condition, and the need to accurately depict the clinical scenario. Upon arrival to the receiving institution, there are a subset of patients who require escalation of resources or higher level of care and result in last minute changes to patient placement. Others are stable and appropriately placed on arrival, suggesting an opportunity for improving accuracy of disposition assessment prior to inter-facility transport. Telemedicine is a reliable adjunct for assessment of critically ill pediatric patients, and has been shown to provide a better shared understanding of patient needs and increase perceived ease of disposition to most appropriate level of care. Objective: To assess feasibility of augmented communication via telemedicine for CCTT communication with medical control while on inter-facility transport; a secondary objective is to assess accuracy of disposition decision. Methods: Prior to implementation of the intervention, baseline observations of communication between medical control and CCTT were conducted, and data was collected on transferred patients’ disposition status (transfer into or out of intensive care unit (ICU) within 6 hours). The intervention was developed with input from institutional stakeholders, and providers from the ICU and CCTT subsequently underwent our institution’s standardized telemedicine training. Following program implementation, prospective data is being collected on the following key metrics: patients requiring >90 minutes of stabilization by CCTT while at originating site, patients requiring transfer to ICU within 6 hours or transfer out of ICU within 24 hours. Results: Data collection and analysis is ongoing and will be reported. Conclusion: The implementation of a telemedicine platform for the LCTT improves communication with medical control, decreases originating site stabilization time, and allows for increased accuracy of patient disposition.
Telemedicine for Inter-facility Transports: Improving Communication and Patient Disposition on Pediatric Critical Care Transports
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Erin Knightly, Dana Aronson Schinasi, Laura Westley; Telemedicine for Inter-facility Transports: Improving Communication and Patient Disposition on Pediatric Critical Care Transports. Pediatrics August 2019; 144 (2_MeetingAbstract): 887. 10.1542/peds.144.2MA9.887
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