90% of hospitals currently accessing the emergency inter hospital transfer protocol.
Protocol 37 has been active for 14 months in the priority dispatch suite used by the National Emergency Operations Centre. The number of transfers are increasing every month as more hospitals are accessing the emergency inter-hospital transfer policy for their patients.
Protocol 37 enables the transferring hospital to designate one of three response times, immediate (Delta), within 30 minutes (Charlie) and within 60 minutes (Bravo). The requesting clinician decides when the ambulance is required, based on these predetermined time frames, to avoid the patient waiting on an ambulance or having an ambulance waiting on a patient. Turnaround times are monitored weekly by the project lead, both within the receiving and transferring hospitals, and information on delays are relayed back to each hospital via identified liaison personnel.
The number of transfers undertaken by the National Ambulance Service (NAS) are growing monthly from fifteen transfers in April 2016 to 282 in May 2017 as shown in the graph below. Weekly, 100% preliminary review of appropriateness of direction of flow of patient is carried out with deep reviews carried out on potential misuse. Response times are also monitored.
Call activity showing the number of transfers, non-compliant transfers and differentiation of time bands requested by the hospitals.
Currently 90% of the hospitals within the seven hospital groups are accessing Protocol 37. The implementation phase of the project is scheduled to complete by September 2017. The following graph depicts the hospital groups which have accessed Protocol 37 for transfers out to other facilities in the month of May 2017. Ireland East Hospital group was the largest user of the protocol in May 2017 requesting 25% of the total transfers out.
During the month of May 2017 the following graph shows to which Hospital Groups the patients were transferred into for their time critical intervention. Of note, the Children’s Hospital Group accessed the protocol a total of 3 times but received 30 transfers into the group under Protocol 37.
As seen from the stats above, transfers that originate within one hospital group will not always transfer to another facility within the same hospital group.