O3328: Ready to Dispatch: Impact of Variables Affecting Time of Transport Completion and Readiness

Background: As part of a hospital system comprised of 3 local campuses, the Houston Texas Children’s Hospital (TCH) Kangaroo Crew (KCrew) provides specialized critical care transport for pediatric, neonatal, and maternal patients from outside hospitals into the system as well as between system hospitals for escalation of care. In reviewing dispatch logs, our TCH Kcrew observed that the time from one transport ending to the time the team was deemed “ready to be dispatched” (RTBD) for the next transport was a very subjective guess from the charge nurse each time. The variability caused transport teams to feel rushed in completing the initial transport and led to dissatisfaction. There was no data to define average time to drop off the transported patient, give report to the receiving facility, and restock equipment to prepare for another transport. We hypothesized that factors such as team composition, patient severity of illness, and location of receiving facility may play a role in the average time needed for teams to be RTBD. The aim of this study was to obtain a median time from arrival at the receiving facility to RTBD and determine the effects of logistical and patient variables on this median time by collecting and analyzing data points in the transport process.

Methods: Transport team members self-reported transitional times when arriving to the receiving facility including time of arrival to facility, arrival at bedside, handoff complete, and restock complete. Variables selected using chart review following each transport included: receiving campus and unit, level of respiratory support, number of medication infusions, refueling of ambulance, and inclusion of advanced provider as part of transport team. Data was collected from September through December of 2024. Data analysis using a linear mixed effects model was used to generate median times and interquartile ranges (IQR) for each variable.

Results: The median RTBD time was 31.9 minutes. The need to refuel the ambulance led to the most significant delay in time to readiness, with an average time of 50 min (IQR 28, 73) compared to 32 minutes without refueling (IQR 25, 43; p =0.0037). Having an advanced provider ride along attributed to a 23-minute longer completion of transport compared to without (p=0.01). All other factors studied did not significantly affect RTBD time.

Conclusion: By defining a median RTBD time and describing characteristics of a transport that may further delay a team, we established a standard for our team. Transport team member satisfaction will be evaluated after the initiation of a trial period using the standard dispatch time. Limitations for our study included voluntary staff participation, accuracy of report times, and better reporting compliance on nights than days.