Effect of a centralised transfer service on characteristics of inter-hospital neonatal transfers

Stephen Terence Kempley ^1*, Yasmin Baki ¹, Graham Hayter ², Nandiran Ratnavel ¹, Elena Cavazzoni ¹ and Teresa Reyes ¹

¹ Barts and the London NHS Trust, United Kingdom
² London Ambulance Service NHS Trust, United Kingdom

^* To whom correspondence should be addressed. E-mail: steve.kempley{at}bartsandthelondon.nhs.uk.

Accepted 15 November 2006

Abstract

Objective: To determine the effects of a centralised neonatal transfer service on numbers of neonatal transfers and the time taken for teams to reach the patient.

Design: Prospective census of neonatal inter- hospital transfers between May-July 2004. Comparison with a previous census performed before introduction of the service. Analysis of requests for antenatal in- utero transfer to the regional emergency bed service.

Setting: Geographically defined area in London and South- East England.

Patients: Babies transferred to or from a neonatal unit.

Interventions: Introduction of a centralised Neonatal Transfer Service.

Main outcome measures: Numbers of transfers, time taken for teams to arrive to the patient (response time).

Results: During the census there were 835 transfers, an increase of 34% from the previous census. Most of the increase was in urgent transfers for neonatal intensive care. There was an average of 4.4 urgent transfers each day, with 3.9 elective and 0.8 short term transfers. Over the same time period in- utero transfers decreased. Response times improved from a median of 2 hours in 2001 to 1.45 hours in 2004 (p<0.05). The 90th centile fell from 6 hours to 4.9 hours.

Conclusion: Following the introduction of a centralised Neonatal Transfer Service, response times improved significantly. An increase in transfers for medical intensive care was associated with a reduced numbers of in-utero transfers. To balance the improved safety and accessibility of neonatal transfer, similar developments may be needed to facilitate in-utero transfer.

Keywords: Ambulances, Infant newborn, Neonatal transport, Transport team

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