Interfacility Question

Ruralmed

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I work full time in a hospital based ems service as a paramedic in a very rural area of southeast Colorado. We staff 4 providers full time with a few other volunteers and cover 911 service as well as IFTs for the hospital. Often we are asked to take patients on interfacility transports that take over 12 hours from start to finish. I was wondering if any services have contracts with other ems agencies that allow a transfer of care at the midpoint of a transfer? Limiting the distance either ems department would have to travel. Or if that’s even a possibility?
 

DesertMedic66

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Outside of an emergency situation I have not heard of this happening. When my ground agency is going to do any long distance transfers such as this, we require early notice and will staff the ambulance with 3-4 providers so that crews can trade off. One drives, one sleeps, one does patient care. They will trade off roles during the transport.
 
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Ruralmed

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Outside of an emergency situation I have not heard of this happening. When my ground agency is going to do any long distance transfers such as this, we require early notice and will staff the ambulance with 3-4 providers so that crews can trade off. One drives, one sleeps, one does patient care. They will trade off roles during the transport.
We have tried this before in the past. It’s a great idea. Our limited staff makes it difficult to keep 911 coverage available as is, and burnout from these requests makes even retaining volunteers difficult. Thank you for your input! Any ideas I can take back to my employer are helpful.
 

MMiz

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At 12+ hours, wouldn't it be cheaper for the patient and more comfortable for the patient to go by fixed wing air?

Can you have the receiving facility pick up and transport the patient?
 

DesertMedic66

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At 12+ hours, wouldn't it be cheaper for the patient and more comfortable for the patient to go by fixed wing air?

Can you have the receiving facility pick up and transport the patient?
It would probably be more comfortable as it would be much more comfortable. It may not be cheaper and insurance may not cover a flight.
 

Ensihoitaja

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Grand County EMS used to do that- they’d intercept with a Front Range service in Empire. Pridemark used to do it, then Rural/Metro did it. I’m not certain if they’re still doing it or not.
 
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Ruralmed

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At 12+ hours, wouldn't it be cheaper for the patient and more comfortable for the patient to go by fixed wing air?

Can you have the receiving facility pick up and transport the patient?
The hospital does fly a good number of patients out depending on the acuity level, but most of their transfers are non-emergent and flight can’t always be justified to insurance companies.
 
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Ruralmed

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Grand County EMS used to do that- they’d intercept with a Front Range service in Empire. Pridemark used to do it, then Rural/Metro did it. I’m not certain if they’re still doing it or not.
Thank you! I’ll look into this further.
 

DrParasite

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I guess my first question is why? 6 hours for a trip is guaranteed $$$

If you are staffing 4 providers full time, I'm assuming that means 2 crews 24/7 right? if there is a long distance transport, that means after one 911 call, your next medical call is mutual aid... what is their ETA? Is that a good thing? how frequently does your area get more than 1 call?

Transferring to another ambulance service halfway sounds like a billing headache; from a revenue-generating standpoint, why would you give up that $?

if it's a long-distance run, could you not bring in off-duty staff to handle the run on OT?
 
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Ruralmed

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I guess my first question is why? 6 hours for a trip is guaranteed $$$

If you are staffing 4 providers full time, I'm assuming that means 2 crews 24/7 right? if there is a long distance transport, that means after one 911 call, your next medical call is mutual aid... what is their ETA? Is that a good thing? how frequently does your area get more than 1 call?

Transferring to another ambulance service halfway sounds like a billing headache; from a revenue-generating standpoint, why would you give up that $?

if it's a long-distance run, could you not bring in off-duty staff to handle the run on OT?
I’m no manager, but I’d sacrifice a portion of revenue to keep employees from burning out. Especially when you can’t find people willing to work in rural settings.
 

johnrsemt

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Transferring mid point is a good/bad way of missing something in the report (oral and written).

I used to do long distance transports in and out of Indianapolis, loved them
now I do them because the closest hospital at my FT job is 42 miles gate to door, and I have been up to 60 miles past the gate.
PT job is 110-140 miles to the hospital from town, and I have been 90 minutes from town so you have to go back to town then to the hospital, about 30% of the time we can't get a bird for even critical patients
 
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