Abstract

Purpose:To describe a novel inter-hospital transport policy for the critically ill. A review of the literature will be included. Methods:A novel policy pertaining to the transport of critically ill patients from our adult surgical intensive care unit is described. An accompanying literature review was conducted using PubMed and Medline databases for English-language articles pertaining to the transport of critically ill patients, both intra-hospital and inter-hospital from 1986 to 2015. Search terms included critically ill, transport guidelines, intra-hospital transport, and inter-hospital transport. Results:A novel policy was developed at our institution for inter-hospital transport of critically ill patients. The policy involves a multidisciplinary meeting with physicians, critical care nurses, respiratory therapists, transport team members and social workers, prior to transfer. A plan and level of care is determined and a document is generated that is linked to the electronic health record. This policy has been implemented and an IRB approved prospective study is underway to evaluate outcomes based on documented adverse events during transport between facilities. The literature review in this manuscript is based on the limited data that exist primarily describing intra-hospital transports of critically ill patients. The limited articles on inter-hospital transport are reviewed and they mainly focus on transfers between facilities for a higher level of care. Conclusions:A formalized set of guidelines based on a novel institutional policy for the safe transport of critically ill patients between institutions is described. This transport tool involves a detailed pre-transport evaluation by key members of the multi-disciplinary team, which is encompassed in the electronic health record. The literature is replete with guidelines for the safe transport of critically ill patients between hospitals and this novel policy will be studied prospectively regarding minimizing adverse events during critical transport.

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