Patient transport often receives less scrutiny from procurement teams compared to other hospital services like imaging equipment or EHR contracts. However, when a stable patient needs to travel long distances, the chosen transport vendor becomes an extension of the hospital’s care. A poorly selected partner can delay discharge, strain case management teams, and leave receiving facilities with incomplete patient information. Long-distance, non-emergency moves introduce additional challenges, including extended travel times, crossing state lines, and managing medications, oxygen, and mobility equipment.
Clinical Responsibility During Transit
One critical question is who holds clinical responsibility for the patient during the trip. Some services provide only drivers, while others include an RN, LPN, or paramedic. It’s essential to confirm the credentials of the staff, whether they remain with the patient throughout the journey, and how staffing aligns with the patient’s acuity. Request written policies for patients on oxygen, those with dementia, or those receiving hospice care, as their needs vary significantly.
For example, a vendor that staffs trips with an RN can offer a higher level of care compared to one relying solely on drivers. Understanding these details ensures the patient’s needs are met during transit, reducing the risk of complications or delays.
Vehicle Equipment and Maintenance
The design and maintenance of transport vehicles are vital to the care provided en route. A clinician unable to comfortably stand or reach the patient faces limitations in delivering care. Procurement teams should request maintenance schedules, safety inspection records, and confirmation that vehicles meet Department of Transportation requirements. Additionally, clarify which equipment is standard and what must be requested in advance, such as bariatric stretchers or extra oxygen supply.
Well-maintained vehicles with appropriate equipment ensure patients receive necessary care during long journeys, minimizing the risk of emergencies or discomfort.
Handoff Procedures at the Destination
The quality of the handoff at the destination is critical to a successful transfer. Request a sample handoff report to ensure it includes vital signs taken during the trip, medications administered, and the patient’s condition upon arrival. Determine whether the transport crew brings the patient directly to the bedside and briefs nursing staff or simply leaves the patient at the entrance. A thorough handoff ensures the receiving facility has a complete and accurate picture of the patient’s condition.
In long-distance medical transport, a seamless handoff can significantly impact patient outcomes and the efficiency of the receiving facility’s operations.
Coordination with Receiving Facilities
Coordination with the receiving facility is another key aspect of patient transport. Tasks such as bed confirmation, arrival timing, and advance notice must be clearly assigned. If the vendor does not handle these responsibilities, they fall to the hospital’s discharge team, increasing their workload. Some vendors that work closely with case managers take on these communication tasks as part of their service, freeing up hospital staff.
Protecting Patient Information
Transport vendors handle protected health information at nearly every step of the process, from intake forms to handoff reports. It’s essential to ask whether the vendor will sign a business associate agreement, how records are stored and transmitted, and which staff members have access to them. Vague answers in this area should raise concerns.
Handling Changes in Patient Condition
On long-distance trips, a patient’s condition may change unexpectedly. It’s important to understand the vendor’s escalation protocol, including who the crew contacts, whether medical direction is available around the clock, and how the decision to divert is made. Confirm how the referring hospital and the patient’s family will be notified in such situations.
Scheduling, Communication, and Billing
Long-distance transports typically require advance notice, though needs can vary. Ask about typical lead times, weekend and holiday availability, and whether one coordinator stays with the case from booking to arrival. It’s also helpful to know whether the referring facility receives updates during transit or only a completion notice. Additionally, understand how the service is billed, when payment is due, and what documentation is provided to support reimbursement claims.
Evaluating and Scoring Vendors
To effectively compare vendors, create a scorecard that weights factors like clinical staffing, handoff quality, and data protection. Involving case managers in shaping this scoring system ensures evaluations are consistent and reflect real-world needs. Regularly revisiting the approved vendor list, at least annually or after any poorly executed transfer, helps maintain its relevance. References from other health systems, particularly those sending patients similar distances, provide valuable insights into a vendor’s performance.
