East of England Adult Critical Care Transfer Service utilises Alertive for emergency transfer coordination

The East of England Adult Critical Care Transfer Service (EOETS) is a vital service that provides transportation and specialist care to critically ill patients between hospitals. These services are crucial in providing timely transportation to patients needing intensive care and helping control the capacity and resources of the region’s Intensive Care Units (ICUs). Time is essential in emergencies, and effective communication is critical for successful outcomes. Considering the immense pressures ambulance services are under, having a separate service taking over these transfers and working in collaboration with ambulance Trusts is necessary to alleviate some of the pressures.

Alertive has established a process with EOETS, which means they don’t have to rely on traditional call handling. The service routes all received referrals through Alertive, which collects information from hospitals requesting patient transfers and passes it directly to the on-call doctor without needing a person to capture the referral information. Effective communication is crucial in patient transfers, as poorly organised transfers can contribute to morbidity and mortality. NHS England has released toolkits detailing the essential elements every ACCTS should have, including a standardised call-handling process and the involvement of a coordinating consultant in referral discussions.

Key Metrics

In one year of service:

1. Total Number of Transfers – 520 transfers: 281 emergencies, 65 capacity, 170 repatriations
2. Miles Travelled – EOETS travelled 71.160 miles throughout 2022
3. Service – 8,760 hours of active service with other 670 referrals

The EOETS implemented Alertive because they wanted to innovate and find new ways to communicate and coordinate care, utilising their staff and resources:

“Critical Care Transfer Services, for adult transfers, is relatively new within the UK, and we wanted to innovate – we wanted to look at models that didn’t rely on traditional call handlers, for example, and made really good use of the staff and the resources that we had. We found Alertive to be really receptive to innovating, setting up a new service and making it meet our needs.” Alistair Steel, Clinical Director, East of England Adult Critical Care Transfer Service

In a healthcare system already under significant pressure, the EOETS is setting an example by implementing innovative solutions that help alleviate some of the pressures on frontline workers. Alertive has enabled the service to provide faster, more efficient, and more consistent care to critically ill patients. It is a testament to the service’s commitment to providing the best possible care to its patients.

• 42.8 seconds median average response time
• 71.1% of alerts received a response in under 2 minutes

The entire communication process and the benefits realised through Alertive are detailed below.

At the start of a shift, staff simply acquire their role – Users can acquire roles from any location, check availability, and access communication records for quick and efficient handovers without time-consuming meetings. This allows for improved situational awareness and enables users to focus on delivering the best possible care for patients.

“We realised it’s imperative that at no stage could we ever not have a duty advice doctor available to take referrals. So we worked closely with the Alertive team to ensure that it wasn’t possible to accidentally give up a role without handing it over to someone else who could take it on. We can now guarantee that there’ll always be a duty doctor at the end of the phone to take those referrals.” Alistair Steel, Clinical Director, East of England Adult Critical Care Transfer Service

When a patient requires a critical transfer, the hospital contacts EOETS, the information is processed, and an alert is triggered – Alertive allows hospitals to communicate directly with the doctor through an online form or phone number. The system automatically collects caller information, saving the doctor’s time. A call handler is not required within this process, allowing more efficient utilisation of NHS staff and resources – redistribution to 999 and 111 calls to deal with higher demand.

“Alertive will look at the area code that the call is received from, and it will turn that area code into the place where the patient is and where the doctor is making the referral. So when alerts come through now, we can immediately see where that alert is coming from, for example, Norwich or King’s Lynn or South End, which helps right from the beginning of that conversation.” Alistair Steel, Clinical Director, East of England Adult Critical Care Transfer Service

The duty advice doctor role receives the alert that a critically ill patient requires a transfer to a hospital – The on-duty doctor will receive alerts, even if their device is on silent. The user acknowledges and receives all the information.

Duty advice doctor contacts the requesting hospital and mobilises the transfer team – Duty clinical director is included in the communication in case help is needed.

“At the touch of a finger, staff can get senior advice without knowing who that person is because the Alertive app will take care of that aspect for them. Using Alertive means they can get in touch for advice very easily. Alistair Steel, Clinical Director, East of England Adult Critical Care Transfer Service

Clear and continuous communication: the importance of information relay to the healthcare team throughout the patient transfer process – Alertive’s two-way communication system enables healthcare providers to send updates to the ambulance team and receive immediate feedback in real-time. The system allows for streamlined communication and does not require back-and-forth calls to request and deliver information. Additionally, the duty transfer doctor can alert their colleagues and call the requesting and receiving hospitals for further information once the ambulance team is informed and en route to collect the patient. This communication process ensures better situational awareness for everyone involved, allowing the EOETS staff to make informed decisions and respond quickly to any issues or concerns. Alertive supports the attachment of photos, documents and voice recordings, enhancing the level of detail available.

Alert secondary transfer teams of a completed transfer, arrival time back to base and current location in case of new patient transfer alerts – Healthcare providers can maximise efficiency by alerting the secondary transfer team that the transfer is complete and providing them with timely and accurate information.