Synergy transport
The descriptions here are the initial developmental steps and are theoretical at this time. Nurses’ characteristics are also a component of the triage decision. It is inspired by the American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care 5 and based on the proposition that transport level of care must be determined by the needs of the patient, including resiliency, vulnerability, stability, complexity, resource availability, participation in care, participation in decision making, and predictability. The purpose of this article is to describe the early development of a new tool for determining necessary level of care during transport. No universally accepted, clear guidelines for making an informed triage decision are available. Experience of the authors (SS, WS, AR), however, indicates that patient-related factors such as predictability and complexity, or transport factors such as adverse weather or road conditions, are not consistently addressed in the triage decision. Typically, the practitioner may decide which transport agency will complete the transport, evaluate the patient’s needs during transport, determine a mode of transport, and specify when the transport should occur. The triage decision regarding the transport of an acutely ill patient requires consideration of multiple factors. 2 The necessity for interfacility transport is increasing for a multitude of reasons, including the development of regional intensive care unit (ICU) facilities and the availability of specialized surgical procedures and time-sensitive interventions. 1 The paramedic level of care is most common in the prehospital setting, but a registered nurse is the primary caregiver in more than 95% of critical care transport missions. This article describes a new tool inspired by the AACN Synergy Model for Patient Care to determine the appropriate level of care required for interfacility transport.Ĭritical care transport includes the interfacility transport of patients who require critical care commensurate with the level of care provided by a physician or registered nurse. This model shows significant promise in providing the theoretical backing to guide the decision on the level of care necessary to complete interfacility transfers safely and effectively. The American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care is a patient-centered model that focuses on optimizing patient care by matching the characteristics of the patient with the competencies of the nurse. A need exists to determine the appropriate level of care required to meet the needs of patients during transport. Typically, the interfacility transport decision is left to the discretion of the referring provider, who may or may not be aware of the level of care provided or the means of transport available. Although numerous tools and algorithms have been used for the prehospital determination of mode of transport, no tool for the transfer of patients between hospitals has been widely accepted.
Today’s health care delivery system relies heavily on interhospital transfer of patients who require higher levels of care.