TRANSFER AND TRANSPORTATION OF PATIENTS

Effective Date: 
Sun, 09/01/2002
Reviewed: 
Sun, 08/21/2011
Revised: 
Fri, 02/03/2017
Policy: 

Patients who require immediate access to further care and evaluation will be transported by appropriate methods to Dominican Santa Cruz Hospital Emergency Department unless on divert status and then will be directed to appropriate designated alternative facility. For patients needing acute psychiatric evaluation and care refer to Crisis Hospitalization Policy and Procedures for Involuntary Hospitalization (5150 Hold).

 
The treating provider is responsible for the decision to transfer the patient, and will direct the selection of receiving facility and mode of transport taking into consideration the acuity of the patient and the safety of the patient during transport.
Procedure: 
1. Indications for Transfer/Transportation
a) unstable condition
b) ongoing medical monitoring or therapy is required
c) patient condition is beyond the scope of practice at UCSC SHS
 
2. Choosing the appropriate destination and means of transport for the patient:
In choosing destination and means of transport, the treating medical staff member will evaluate
a) the patient’s stability and potential for decompensation en route to the receiving facility.
b) any special circumstances required during transport (eg. Immobilization, advanced airway management, cardiac arrhythmia)
 
3. Urgent and Emergent Cases will be transported to the Emergency Room at Dominican Santa Cruz Hospital Emergency Department unless on divert status and then will be directed to appropriate designated alternative facility.
 
4. Ambulance Transport is Indicated for Patients
a) whose condition is unstable (head injury, abdominal pain, active bleeding)
b) who require special handling during transport (immobilization, emesis, severe pain)
c) who require medical monitoring during transport
d) for whom immediate further evaluation is necessary
 
5. Private Vehicle Transportation
  Transport in a private vehicle is contraindicated if the patient is driving themselves when there is a condition which would potentially impair their ability to drive (eg, extremity injury, significant pain). In these cases, another driver may be sought to drive the patient’s vehicle or give the patient a ride. Patients with stable vital signs and stable medical conditions may be transported in a private vehicle. Staff are not authorized to provide transportation in private vehicles.
 
6. Making Transportation Arrangements
Emergencies
a) Call 911 and advise dispatcher that  Ambulance Transport from the Student Health Center to Dominican Hospital is required. A diagnosis or chief complaint should be given. The time of the call will be documented in the medical record.
b) The treating clinical staff member should make direct contact with the receiving physician/facility to obtain acceptance of the transfer and document in the medical record.
Non-Emergent Transfers
c) Non-emergency ambulance transfers should be arranged through campus dispatch at 911.  Inform dispatch of the nature of the problem, our location and the destination.
d) Taxi transport for appropriate patients can be arranged .  Taxi vouchers are available. Two vouchers may be given if transportation to and from the hospital or doctor’s office is needed.
 
7. Role of Paramedics
a) Paramedic crew will assume responsibility for the patient on their arrival at the scene, and will treat patients according to their protocols.
b) The UCSC physician remains at the health center and communicates with the ER physician by phone.
 
8. Documenting Transport/Transfer of Patients
a) Document that the receiving facility was notified and accepted the patient for transfer in the electronic medical record using the hospital transfer section.
b) A copy of the draft progress note should accompany the patient, containing the essential findings and summary of care provided at UCSC SHS, along with the patient’s condition at the time of transfer.
c) An Incident report will be created for all transfers.
d) If appropriate, request that the student sign the Release of Health Information to allow the Student Health Center to contact Student Services.  If the student signs this, document that Student Services was notified.  This allows Student Services to offer support services to students with unexpected medical situations.