A Safe Escort Programme for Paediatric Patients

Abstract Description

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Authors (including presenting author) :

Yau MM(1), Cheung MY(1), Lui MW(1), Chan TW(1)

Affiliation :

(1)Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital

Introduction :

Paediatric patients are frequently escorted to other institutions for necessary interventions. Safety is our top priority. Whilst guidelines and forms exist in different paediatric departments, an established paediatric transport programme is currently lacking. Patient escorts carry different levels of risks, which depend on the underlying diagnosis, hemodynamic status and the transport arrangement. Timing of transfer, pre-transfer treatment, preparation and risk management are vitally important to enhance patient safety. Over the years, our department has been refining our paediatric transport programme to meet this goal.

Objectives :

A multi-disciplinary safe escort group, consisted of medical and nursing staff, was set up in 2015 to overlook the safe escort programme. The aims were: (1) To develop clinical risk management and quality improvement strategies. (2) To monitor and review quality improvement and risk reduction measures. (3) To provide relevant education and training.

Methodology :

The group develops transport guidelines, forms and checklists for various disease categories. That includes transport consideration guidelines for various conditions, transport checklists, standardized referral letters and audit forms. Transport cases are reviewed in regular and ad-hoc meetings. Relevant educational debriefing notes will be produced for staff empowerment. Audits on various aspects of patient transport are conducted for service quality improvement purpose. The group also leads intra-department training sessions and conducts regular training drills. The group also supports other clinical departments, such as Accident and Emergency Department, for related paediatric safe escort issues.

Result & Outcome :

Our model of safe escort programme aims at enhancing safety in the transport process in a regional hospital. The whole transport process will be streamlined and standardized. We also target at improving staff competence and compliance to the guidelines. From 2015 till now, 216 patients required inter-hospital transferal. Most of them were emergency transfers. 70 (32%) of them were in critical clinical conditions required NICU/PICU admissions. These patients suffered from various neonatal, paediatric or surgical conditions. There was no patient deaths related to the transferal procedure. With the opening of Hong Kong Children’s Hospital (HKCH) which adopts a hub-and-spoke model, timely and safe patient transfer process will play a pivotal role in its service provision. A comprehensive and robust paediatric transport programme shall be developed in all regional hospitals to maintain a high quality patient transport process.