Assessment of patient safety during interfacility transport

Objective

The transport of critically ill pediatric patients is associated with the occurrence of adverse events (AE) and incidents that worsen patient outcomes. The primary objective was to determine the AEs and incidents that occurred during interhospital transport and to analyze changes after the implementation of safety measures. The secondary objective was to analyze the association between the presence of family accompanying the patient in the ambulance and the number of incidents.

Material and methods

Prospective and observational study, including patients transferred by a specialized pediatric transport team during two periods: period 1 (2017-2018) and period 2 (2022-2023). We compared incidents in the two periods after the implementation of safety measures. We also compared the presence of parents during the transport and its association with the occurrence of incidents.

Results

We analyzed 1369 transports. A total of 273 (20.7%) patients experienced some incident during transport, with a lower percentage in period 2 (29.2% vs 12.0%; P < .001), especially in patients with clinical incidents (20.3% vs 5.1%; P < .001). Incidents involving a lack of devices or supplies were least frequent, with no differences between the two periods.

Family accompanied the patient in the ambulance more frequently in the second period (76.0% vs 82.6%; P = .001), a finding that was not associated with an increase in incidents, with a higher percentage of transports with parents in the care cabin.

Conclusions

Interhospital pediatric transport performed by teams trained in clinical safety leads to few incidents. Implementing measures to improve patient safety can reduce the frequency of these incidents and optimize care quality.