Road trips and resources: there is a better way

BACKGROUND: Transport of critically ill patients for diagnostic and/or therapeutic management involves significant consumption of resources. In an effort to improve the delivery of care to these patients and decrease resource utilization, Hill-Rom (Batesville, IN, USA) have developed a self-contained device (CarePorter(TM)) designed to provide both intensive care unit (ICU) support and transport capability. We hypothesized that the use of the CarePorter when compared with a standard or specialty bed (with transfer to a stretcher) would decrease the number of personnel and time required for transport without altering the current ICU standards of care. RESULTS: Over a 3 month period, 35 ventilated patient transports were divided into the following groups: specialty bed to stretcher (n = 13), standard bed (n = 9) and CarePorter (n = 13). The APACHE II score at the time of transport was not different between the groups, nor was the ongoing care being delivered. The CarePorter group had a statistically greater fractional inspiration of oxygen and positive end expiratory pressure, when compared with the other two groups (P < 0.05). The use of the CarePorter device decreased the number of personnel required to transport a patient (2.1 ± 0.3 vs 3.6 ± 0.5 for the standard bed and and 3.2 ± 0.7 for the specialty bed; P = 0.0001). The CarePorter also decreased the number of resources utilized for the preparation of a patient for transport (P = 0.001) when compared to the other groups. This was primarily due to the transfer of patients from specialty beds to a stretcher. Overall respiratory therapy time was also much less with the CarePorter (5.9 ± 5.7 min), when compared with the standard (26 ± 10 min) or specialty bed (22 ± 11 min) (P = 0.0008). In addition, the CarePorter group also had a higher nursing satisfaction score with the overall transport (P = 0.008). CONCLUSIONS: Use of the CarePorter device resulted in maximization of the delivery of patient care, time savings, significantly improved utilization of escort personnel