P3.262: Improving Dispatch Delays for Emergency Transport

Purpose/Objectives: To expedite care to vulnerable populations, the team at a tertiary pediatric facility has set an internal benchmark of 20-minute dispatch times for all patients accepted from outside facilities. The team implemented a quality improvement (QI) initiative to improve this benchmark for all transfers into the facility. Data for 2021 showed an average of 47% of transports had a delay in dispatching for floor (non-ICU) patients. In response to this, a STATdispatch protocol was initiated. In 2022 and 2023, there was no improvement and dispatch delays continued at 48% with an average dispatch time of 123 minutes. In response to this, the House Supervisors and transport team implemented an algorithm to include the House Supervisors in the dispatch decisions for floor patients.

Design/Methods: The goal of this QI project is to reduce the time from patient acceptance to transport team dispatch and improve compliance with the established in-house benchmark and GAMUT mobilization metrics by 20 precent. While the GAMUT metric measures total mobilization time, the team hopes improving dispatch times will assist in moving closer to the current GAMUT average of 53 minutes. Using this established benchmark, published transport guidelines, and local consensus, interventions were developed with relevant stakeholder input for use at the institution and with transport team members. Intervention implementation included educational presentations with inpatient managers and charge nurses, and staff meeting follow-up was completed with 42 transport team members (nurses, respiratory therapists, and physicians), the house supervisor team, and 15 Access Center staff members from 2023 to current. Data was collected from electronic transport records and reviewed by a QI team of representatives from Transport and House Supervisors. The metric was measured as the average minutes from patient acceptance to dispatch of the transport team as this is also the established in-house metric.

Results: In November 2023, the first PDSA cycle was implemented with initiation of the algorithm. After implementation of the first PDSA cycle, there was a shift in median dispatch time from 153.6 minutes to 62 minutes, a 60% decrease, which far exceeded our initial goal of 20%. Leading up to the second PDSA cycle there was a greater variability, which then decreased after the second and third PDSA cycles. We hope to continue to follow the data to try to get closer to the GAMUT average of 53 minutes.

Conclusion/Discussion: Data collection from post-implementation periods is ongoing. By September, data analysis into the implementation period should be completed and initial impacts on measured metrics will be better appreciated.