Protocol 37-The Emergency Inter-Hospital Transfer Policy

Protocol 37 has been developed for emergency inter-hospital transfers for patients who require a clinically time critical intervention which is not available within their current facility.  Protocol 37 is the latest protocol to be added to the priority dispatch suite used by the National Emergency Operations Centre/HSE National Ambulance Service.

The aim of the health service is to deliver high-quality safe care at the right time and in the right place resulting in positive patient experiences and outcomes. To achieve this, it may become clinically necessary to transfer a patient from one hospital to another to receive treatment that is unavailable in the referring hospital.

The National Emergency Operations Centre receive a range of requests that exceed the resources available to them. Conflicting demands for ambulance transport exist, therefore the service has to triage the calls to identify priority levels to ensure resources are prioritised. Protocol 37 ensures that all emergency inter-hospital transfer requests are filtered and prioritised by the National Emergency Operation Centre staff, ensuring that the patient gets to the correct destination in the proper timeframe.

 It is important to note that Protocol 37 requests will always compete for ambulance resources that are prioritised to deal with out-of-hospital 112 (999) emergency call incidents. All hospital based healthcare personnel should be aware of the potential cost and significance of tasking an ambulance for an emergency transfer as it results in the withdrawal of an ambulance, for availability, to respond to local community emergencies.

All requests for emergency inter-hospital transfers are made through the 112 (999) call system ensuring that each call is answered promptly by Emergency Call-Takers and allocated the appropriate priority. A pro forma document has been developed to streamline the process for requesting an emergency inter-hospital transfer allowing the hospital staff to order an emergency inter-hospital transfer in a clear and focused manner.

Protocol 37 has been operational since the 11th April 2016. Each hospital must undergo an education process prior to accessing Protocol 37 and currently 44% of the hospitals are accessing the emergency inter-hospital transfer process for their patients.

Protocol 37 aims to provide patients with an emergency inter-hospital transfer facility that is appropriate and timely, resulting in positive outcomes for our patients.

Protocol 37 Activity - 2016

Month  Number of transfers
 April 15
 May 48
 June 53
 July 66
 August 65
 September 63
 October 84
 November 103