O3284: Auto-launch: Improving “out of Chute” for Time Sensitive Diagnoses by a Critical Care Transport Team

Purpose/Objectives: Our interfacility pediatric and adult critical care ground transport team had historically long dispatch times for time sensitive diagnoses. Existing practice included the transfer center obtaining a full report from the requesting facility, then relaying the information to the team, prior to dispatch. We engaged in a quality improvement process to decrease dispatch times for time sensitive diagnoses for optimal patient outcomes. This change involved the development of an auto-launch dispatch process aimed at improved dispatch to response time of our transport team for diagnoses where time to definitive care has a high impact on patient outcomes. Our goal was to have the team enroute within 12 minutes from the start of the transfer request.

Design/Methods: Patient diagnoses for inclusion into the pilot were selected based on need for timely interventions. Cardiac arrest, pediatric patients ( < 18 years of age) at high risk of deterioration, pediatric or adult trauma, stroke, and STEMI were selected. A retrospective review of patient charts and transport records starting 6 months before the pilot was completed to obtain baseline time metrics. On October 1, 2022, a new auto-launch process was implemented for the above diagnoses. Upon transfer request, the team is instantly dispatched with only sending facility information, age, weight, and diagnosis relayed (see Figure). Once the team is enroute, a call is placed to the transfer center for full report and information on patient destination (ED, ICU, Floor). The same methods and criteria were utilized to compare times before and after auto-launch implementation.

Results: The retrospective review of patients from April 2022-September 2022 found 59 patients transported who met criteria for auto-launch dispatch. Average time from start of transfer request to dispatch of the team was 6 minutes, with average time to team pulling out enroute to referring facility 25 minutes, for a combined total of 31 minutes. Data review post auto-launch from October 2022-March 2023 found 46 patients that met criteria with auto-launch dispatch being utilized. Average time from start of transfer request to dispatch was 3.5 minutes with average time to team enroute 9 minutes for a total of 12.5 minutes (see Graph). Five additional patients were identified during post review that met auto-launch criteria, however, failed to be auto-launched by the transfer center. Staff education was provided for process improvement.

Conclusion/Discussion: This pilot quality improvement study found that initiation of an auto-launch process utilizing pre-defined dispatch criteria improved our transfer request to transport team enroute time by 18.5 minutes for time sensitive diagnoses. This pilot project shows that decreasing response time is achievable. We will continue to educate staff to improve this process and consider adding additional diagnoses to the list.