Operational Impact of a Critical Care Transport Duty Time Tool Implementation: A Quality Improvement Project to Enhance Crew and Patient Safety

Abstract

ObjectiveThe Commission on Accreditation of Medical Transport Systems requires transport programs to have operational risk assessment tools that must address issues such as transport acceptance with tools for assessing pilot/driver and crew alertness and fatigue, aviation decision making, and mission acceptance/medical decision making. The objective of this study was to evaluate the impact the implementation of this tool has on programmatic operations. MethodsThis hospital-based dedicated pediatric/neonatal transport team has experienced rapid increase in volume as well as an expanding response area. Data related to calls resulting in excessive on-duty time were evaluated for 2 years before and after the implementation of a formal risk assessment program that included duty time assessment. ResultsSince the implementation of the duty time assessment tool, there has been a 48% decrease in calls resulting in crews being held over 1 hour past their shift. Additionally, there has been no decline in transport requests, and the resultant increased safety awareness has led to a decreased risk of incidents related to crew and driver fatigue. ConclusionThe implementation of a risk assessment tool not only increases crew safety and subsequently patient safety, but also it has no negative impact on referral pattern or volume.