Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Mathews, Maria

2nd Supervisor

Gunz, Anna

Co-Supervisor

Abstract

Introduction: This retrospective cohort study evaluates the impact of a dedicated ambulance on dispatch times of pediatric transports to the London Health Sciences Centre using the Canadian Pediatric Transport Network (CPTN) database.

Methods: After assessing the data quality of the CPTN database, we used multiple linear regressions to examine differences in dispatch times before and after June 2019, when a dedicated ambulance was introduced.

Results: We found that additional measures are needed to improve data quality in the CPTN database. A dedicated ambulance improved ambulance return times but not dispatch times.

Conclusion: Ongoing quality assessment is necessary to improve the CTPN. Additional research is needed to investigate the cause of dispatch time delays.

Summary for Lay Audience

Critically ill children often receive basic medical care and stabilization in their local hospitals but require transfer to a tertiary pediatric facility for specialized medical or surgical care. The goal of interfacility transport is to transport patients from referring local hospitals to specialized pediatric care centres at a standard as similar as possible to the care provided in pediatric critical care units. In Ontario, children under the age of 18 are transported by Ornge Transport Medicine, a nonhospital affiliated air medical transport agency, or by hospital-based teams, such as the transport team at the London Health Sciences Centre (LHSC). Interfacility transports are dangerous procedures because patient monitoring while in transit is difficult in addition to having limited medical resources. Thus, patient transports are ideally carried out in the shortest amount of time possible. One method that has shown to allow for shorter ambulance dispatch times is by having a dedicated pediatric ambulance, as it limits the need to rely on or coordinate transport with third parties. Since June 2019, transports by the London Pediatric-Neonatal Transport Team at the LHSC have been completed with a dedicated and specially equipped pediatric ambulance. We used the Canadian Pediatric Transport Network, a health administrative database, to assess whether having a dedicated ambulance was associated with shorter dispatch times. We found that having a dedicated ambulance improved ambulance return times to the LHSC but not dispatch times. Although a dedicated ambulance is a necessary resource, additional research is needed to investigate the cause of dispatch time delays to enhance the transport program at the LHSC.

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