High acuity rural transport: Findings from a qualitative investigation

High acuity rural transport: Findings from a qualitative investigation

Introduction: The High Acuity Response Team (HART) was introduced in British Columbia (BC), Canada, to fill a gap in transport for rural patients that was previously being met by nurses and physicians leaving their communities to escort patients in need of critical care. The HART team consists of a...

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Bibliographic Details
Published in:Rural and remote health Vol. 18; no. 2; pp. 1 - 11
Main Authors: Kornelsen, Jude, Hobbs, Brent, Buhler, Holly, Kaus, Rebecca, Grant, Kari, Lamont, Scott C, Grzybowski, Stefan
Format: Journal Article
Language:English
Published: Townsville QLD James Cook University 01-01-2018
Subjects:
British Columbia
Collaboration
Cooperative Behavior
Critical care
Critical Care - organization & administration
Critical care medicine
Effect of managed care on
Emergency Medical Dispatch - organization & administration
Emergency medical services
Emergency Medical Services - organization & administration
Emergency services
Health aspects
Humans
Interinstitutional Relations
Interviews
Medical personnel
Medical referrals
Nurses
Nurses - organization & administration
Patients
Physicians
Qualitative Research
Respiratory Therapy
Rural areas
Rural development
Rural health care
Rural health services
Rural Health Services - organization & administration
Sustainable development
Teams
Transportation
Transportation of Patients - organization & administration
Workforce planning
Australia
Canada
Scandinavia
sustainable rural health services
Canada
qualitative research interviewing
rural patient transport
innovative rural healthcare models
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Summary:Introduction: The High Acuity Response Team (HART) was introduced in British Columbia (BC), Canada, to fill a gap in transport for rural patients that was previously being met by nurses and physicians leaving their communities to escort patients in need of critical care. The HART team consists of a critical care registered nurse (CCRN) and registered respiratory therapist (RRT) and attends acute care patients in rural sites by either stabilizing them in their community or transporting them. HART services are deployed in partnership with provincial ambulance services, which provide vehicles and coordination of all requests in the province for patient transport. This article presents the qualitative findings from a research evaluation of the efficacy of the HART model, including staffing and inter-organizational functioning. Method: Open-ended qualitative research interviewing was done with key stakeholders from 21 sites. Research participants included HART CCRNs, RRTs, administrative leads, as well as local emergency department (ED) physicians and nurses. Thematic analysis was done of the transcripts. Results: A total of 107 interviews in 21 study sites were completed. Participants described characteristics of the model, perceptions of efficacy and areas for improvement. Rural sites reported a decrease in physician- and nurse-accompanied transports for high-acuity patients due to the HART team, but also noted challenges in delayed deployment, sometimes leading to adverse patient outcomes. Conclusions: The salient issues for the HART model were grounded in a somewhat artificial distinction between pre-hospital and interfacility transport for rural patients, which leads to a lack of service coordination and potentially avoidable delays. A beneficial systems change would be to move towards dedicated integration of high-acuity transport services into hospital organizational structures and community health services in rural areas.
Bibliography:Rural and Remote Health, Vol. 18, No. 2, May 2018, 1-11
Informit, Melbourne (Vic)
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1445-6354
1445-6354
DOI:10.22605/RRH4316