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Kempsey Patient Transport Project

Mid North Coast Local Health District
Project Added:
6 January 2016
Last updated:
20 January 2016

Kempsey Patient Transport Project

Summary

Mid North Coast Local Health District (MNCLHD) upgraded the Patient Transport Service (PTS) and expanded its capacity to provide after-hours services. It also educated emergency department (ED) staff on how to use these services most effectively.

Aim

To provide timely transfer and improved patient access for patients transferring from Kempsey District Hospital (KDH) ED to Port Macquarie Base Hospital (PMBH) ED.

Benefits

  • Provides safe, timely, cost-effective transport for patients.
  • Improves patients’ access to specialist healthcare.
  • Improves resource management and reduces transport costs.
  • Increases clinician engagement and awareness of patient transport options.
  • Improves collaboration with multidisciplinary teams, health transport units, NSW Ambulance and other services.
  • Improves access to ED beds at KDH.
  • Increases ability of NSW Ambulance to respond to emergency transfers.

Background

Hastings Macleay Clinical Network set out to improve the PTS and reduce the significant costs incurred by booking transfers with NSW Ambulance. Prior to this project, all admissions to Kempsey ED that required transport outside the hours of 08:30 to 17:00 relied on NSW Ambulance. This frequently resulted in lengthy delays for patients requiring specialist care.

Due to the reliance on NSW Ambulance during out-of-hours periods, NSW Ambulance was experiencing high overtime rates and staff fatigue, as well as penalties for transfers of non-emergency patients from KDH to PMBH.

Implementation 

  • Discussions were held with MNCLHD staff including nursing staff, medical staff, pharmacy, the acute pain service and biomedical engineering. This enabled a multidisciplinary approach to improving the PTS.
  • Transport procedures and guidelines were updated so that stable, cardiac-monitored patients could be transported, including those who presented with a fractured hip.
  • The PTS extended its hours from eight hours per day (08:30- 17:00) to 16.5 hours per day (07:30 to 24:00). The after-hours service is based at KDH ED.
  • Patient-controlled analgesia (PCA) was implemented during patient transport.
  • An education blitz was provided to PTS staff, ED staff and nursing management. It was provided by a nurse escort who acted as a champion for this project. This education will now be provided as part of transport orientation for new PTS staff. Yearly refresher sessions are planned for ED staff and nursing management. 
  • New equipment was purchased for patient transport vehicles, including cardiac monitors, PCA pumps and intravenous pumps. Although much of this equipment was already available within the hospital, new equipment stored in the vehicles ensured that suitable patients could be transported without delays due to sourcing equipment or waiting for an appropriately-equipped vehicle.
  • All changes to this service were required to comply with the following NSW Health policy directives:
    • Service Specifications for Transport Providers NEPT PD2014_013
    • Medication Handling in NSW Public Health Facilities PD2013_043.

Graph 1: Cases unable to be transported by the Patient Transport Service.
Graph showing decrease in ambulances booked during project

The purple line in the above table shows a decrease in the number of Ambulances booked by Kempsey District Hospital during the project implementation period. 

Key dates

  • Project start: May 2014
  • Project finish: October 2014

Project status

Sustained - The project has been implemented, is sustained in standard business.

Implementation site

  • Kempsey District Hospital 

Partnerships

  • NSW Ambulance
  • Port Macquarie Base Hospital

Results

  • Achieved net savings in ambulance costs of approximately $242,277 within six months.
  • Transported an additional 299 patients from KDH to PMBH, between May and October 2014.
  • A permanent full-time patient transport officer was recruited to continue the after-hours service at KDH, following the pilot project.
  • Overtime rates and fatigue for NSW Ambulance staff was reduced in the Kempsey area.
  • Staff awareness of other methods of patient transport increased, demonstrated by a reduction in ‘Ward Booked Direct’ ambulance bookings from KDH ED. Staff education in July 2014 further improved these rates, with ambulance bookings reduced from 46 per month to 20 per month (see graph 1).
  • The model of care is now being replicated at Macksville Hospital and several other sites in MNCLHD and Northern NSW Local Health District.

Awards

  • MNCLHD Quality Award Winner 2015.
  • ACI Innovation Award Winner 2015.

Lessons Learnt 

The use of a project lead was instrumental to coordinating and promoting this change in practice. Executive support for the project lead and a willingness to improve this service was also vital to staff engagement.

Contact 

Cate Coles
Nurse Manager, Patient Transport Service
Mid North Coast Local Health District
Phone: 02 5524 2563
Catriona.Coles@ncahs.health.nsw.gov.au

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