The Sunshine Coast Hospital and Health Service (SCHHS) identified a need for an experienced medical and nursing retrieval team to road transfer critically ill patients within the district during the COVID-19 pandemic. The SCHHS contains five health facilities spanned across 100km, a distance normally requiring rotary service. The SCHHS response was initiated to ease burden on RSQ during the pandemic, improve response capability to ensure quality patient care and improve district expertise.
Sunshine Coast Covid-19 response retrieval service
Initiative Type
Model of Care
Status
Deliver
Added
Last updated
Summary
Key dates
Mar 2020
Dec 2020
Implementation sites
All Sunshine Coast HHS hospitals
Partnerships
All Sunshine Coast HHS hospitals
Aim
The SCHHS Retrieval Services aims to prioritise and safely facilitate the transfer of critical care adult patients from SCHHS peripheral hospitals to SCUH (predominantly ICU) where capacity is centralised.
Benefits
- Improve district expertise with staff members from multiple emergency departments (ED), strengthen a connected culture in district, create positive relationships between ED and retrieval service, provide expert critical care of patients during retrieval process. Training Day- 64 nursing and medical staff completed SCHHS wide.
- Five Retrieval Case Forums were held, SIM IHT education presented at Noosa and Maleny Hospitals.
- Nambour Hospital ED have adopted and adapted the Retrieval Service processes to be able to support their own critical care Inter-hospital Transfers, now meeting ANZCA and ACEM guidelines standards.
- Assistance was provided in reducing emergency length of stay for peripheral ED's by reducing wait time for Retrieval Services Queensland activation, especially at Gympie Hospital.
- Providing rapid tertiary level emergency support to Maleny hospital through activation of retrieval team.
Background
Sunshine Coast HHS has one of the largest numbers of inter-hospital transfers and critical retrievals in Queensland. At the beginning of the pandemic Retrieval Services Queensland asked the hospitals to increase their capacity to perform their own critical care transfers.
Solutions Implemented
Rapid activation of localised team comprising of:
- Senior Medical Officer (SMO) with retrieval experience
- Emergency Clinical Nurse.
- Safety and Quality Processes implemented:
- monthly case reviews/audits of every case, clinical incident reporting, case report sent to directors and NUMS of EDs, case report to be placed on agenda of communicating for safety committee meetings.
- monthly data reports of all medically escorted IHTs within health service.
- vehicle orientation package
- monthly case reviews/audits of every case, clinical incident reporting, case report sent to directors and NUMS of EDs, case report to be placed on agenda of communicating for safety committee meetings.
- risk screening on coordination form.
- data reporting of retrieval team response times
- Retrieval Team IV medication guide published
- Group A Procedure Retrieval Framework developed in consultation with key stakeholders including Emergency, ICU, Facility representatives, PACH, RSQ
- consumer feedback questionnaires
- staff feedback questionnaires.
- Equipment and Process:
- bespoke equipment purchased for three main facilities (Sunshine Coast University Hospital, Nambour General Hospital and Gympie Hospital) including safety rated equipment bridge with brackets, retrieval video laryngoscope, emergency access device
- equipment Checklists and patient safety checklists to support staff and ensure safe processes occur during retrieval
- bridge orientation video produced
- development of an education program to support staff on the retrieval team allowing for further specialisation of nursing staff and senior registrars.
Evaluation and Results
The retrieval service supports all facilities within the SCHHS. Highest activation rates occur between Nambour and Gympie facilities with 42% occurring from Nambour Hospital and 35% from Gympie Hospital. Maleny, Noosa and out of district retrievals 23%.
Lessons Learnt
Lessons learnt
• the importance of a robust clinical governance framework
• clear safety and quality processes
• documentation that supports staff to provide exceptional care, gathers meaningful data and doesn't waste staff time
• diverse educational opportunities
• gathering a motivated team that believe in the cause
• capture data from the outset and learn how to use excel
