Hospital discharge transportation involves the methods used to transport a patient from the hospital to their home, a rehabilitation center, nursing home or other care facility. How hospitals and patients handle hospital discharge transportation is a key element to the success of overall medical treatment.
It’s an issue that all healthcare providers address. Hospital discharge transportation is seen as part of a comprehensive approach to patient care. That applies whether the patient needs medical transportation home or to another facility.
In some cases, transportation may involve having to fly commercial after surgery. This happens when patients are injured while on business travel or vacation. It also is necessary for those who must fly to get care from a specialist surgeon.
Medical professionals put a great deal of focus on discharge planning process because transportation from a care facility is a time when people are vulnerable. Every detail of hospital discharge transportation focuses on patient safety, including medical transportation home.
Also, effective discharge lowers the chance of a patient returning to the hospital because patients and their families are prepared for the transition. That’s why addressing the patient’s traveling requirements is critical.
In situations where flying is involved, hiring a non-emergency medical transport service is often the right move. They provide service that includes making all travel arrangements, including ground transportation, navigating the airport and flight reservations.
They also provide a flight nurse who is certified in aviation physiology and can handle any medical situations that may arise while in the air.
When working on discharge planning, medical staff find the best way to provide a smooth transition from one facility to another, or to the patient’s home. Only doctors can authorize discharge from a hospital. However, social workers, case managers or nurses often oversee discharge planning.
According to the National Center on Caregiving (NCC), discharge planning revolves around the following issues.
Evaluation. Qualified personnel evaluate the patient’s condition.
Discussion. A patient or her representative discuss discharge with qualified personnel
Planning. Plan revolves around either going home or to another institution.
Determining. Qualified personnel determine whether the patient’s caregiver needs training or other support
Referrals. The medical facility refers the patient to the appropriate support service, such as a home health agency
Follow up. Discharge planning also involves making arrangements for follow-up appointments or tests for the patient.
Many medical facilities continue to work in this critical area, so it’s important for patients to know their options and the challenges involved with discharge. For example, research reported by the NCC indicates about 40% of patients over the age of 65 had medication errors upon release from the hospital. Also, about 18% of Medicare patients discharged from hospitals are readmitted within 30 days. Those numbers underscore the importance of hospital discharge transportation. For patients who know they have an upcoming hospital stay, all options – including non-emergency medical transportation – should be investigated.
Patients use medical transportation in both emergency and non-emergency situations. Medical transportation options include non-emergency services such as wheelchairs, medical couriers, ambulatory services, travel arrangements and flight nurses. Emergency services include basic life support ambulances, advanced life support ambulances and air ambulances.
The following provides an overview of some of the common medical transportation options used by patients.
Benefits of Medical
Transportation
Every medical transportation option has benefits because they all effectively and efficiently get patients to their destination. En route, experienced medical personnel, including doctors and nurses, provide medical services as needed.
In non-emergency medical
transportation (NEMT), the ability to schedule everything ahead of time and
travel with a flight nurse provides enormous benefits to patients. Rather than
take on the challenges of travel alone, they have the peace of mind of having
trained medical experts with them.
Types of Medical
Transportation
The following offers a list of medical transportation options for patients. All choices fit into two major categories: emergency transportation and NEMT.
Non-Emergency
Medical Transportation
NEMT is the best medical transportation option for those with a medical condition or injury that does not pose an immediate threat. Typically, older patients, those with disabilities or those who have difficulty with mobility from an injury use NEMT. Professional NEMT service companies such as Flying Angels can make all travel arrangements and assign a flight nurse to travel with patients. The company offers the service for domestic and international flights.
The specific types of
transportation used in NEMT include the following.
Wheelchair
A very common form of transportation in non-emergency situations. Patients use wheelchairs if they have difficulty walking for long distances through the airport and from ground transportation into the airport. Special, narrow wheelchairs are used on planes. Flight nurses ensure that plane personnel safety store personal wheelchairs during flight.
This is typically a car
or van that takes patients to and from the airport. It’s one of the commonly
used forms of NEMT transport. It’s designed for those who can walk with little
to no assistance.
Flight Nurses
Flight nurses are a key
element in NEMT. They travel with patients to their destination. They have
years of experience and a high level of expertise in providing any medical
services needed during a flight. They oversee a patient’s medications and
monitor their health. Upon arrival, they arrange any ground transportation
needed to get a patient to their destination.
Medical couriers safely transport blood, organs and other human biological specimens between hospitals or research facilities. All medical couriers must meet government regulations, including provisions of the Health Insurance Portability and Accountability Act.
Stretcher
Used only in
circumstances where a patient has an injury that prevents them from standing or
walking but is not an emergency situation. This option is limited to
international flights on a few selected airlines.
Emergency Medical
Transportation Options
Just as the name implies, emergency medical transportation options are used when patients are in a medical crisis and need transportation to a hospital as quickly as possible. The emphasis in all these areas is finding a balance between safety and speed.
Ambulances are typically in one of two
categories: basic life support and advanced life support.
Basic Life Support
Ambulances
A basic life support ambulance offers medical
service from emergency medical technicians during transportation to a hospital,
rehabilitation clinic or testing facility. Medical supplies and equipment on a
basic life support ambulance include defibrillators, aspirin, EpiPens,
pulse oximetry, intranasal naloxone administration, splints, bandages, oxygen
tanks and masks, and spinal immobilization equipment.
Advanced Life
Support Ambulances
Advanced life support ambulances have equipment
that monitors vital signs, as well as advanced drug therapy, cardiac
monitoring, oxygen and IV therapy. All services are administered by a highly
skilled paramedic or nurse.
Air Ambulances
Air ambulances include helicopters and fixed wing aircraft. Typically, a helicopter transports those in immediate need of clinical treatment, including victims of car accidents, violent crime or natural disasters when time is the absolute imperative. Fixed wing air ambulance is utilized over greater distances with acutely ill patients who patient who cannot tolerate sitting. The situation dictates the type of transportation used. Decisions on emergency transportation are made by medical personnel, while patients decide on non-emergency transport. For NEMT, a service like Flying Angels offers all the advantages and benefits you need and choices for how you want your transportation planned.
Aviation physiology focuses on how flying impacts the physical and mental health of the pilots, flight crew and passengers. It’s an area of health science in which flight nurses develop expertise because their “work environment” is thousands of feet in the air.
Aviation physiology provides a framework for dealing with how air travel impacts human beings, according to the Federal Aviation Administration. The FAA Facts provided in a guidebook acknowledges that “every human is physiologically different and can react differently in any given situation.”
However, medical professionals have developed strategies for dealing with anxiety, stress and other health issues that people may experience, including those involved with commercial flight medical transportation and assisted flight travel.
The Basics of
Aviation Physiology
Humans can adapt to a
remarkable number of different environments. For exploring the ocean depths to
traveling into space, humans can adjust to changes in external temperature,
barometric pressure variations, motion in space and changes in relation to
gravity.
However, these changes can have an impact. When
it comes to flight, the FAA points out three major areas where environmental
changes have the biggest impact:
Marked changes in barometric pressure
Considerable variation in temperature
Movement at high speed in three dimensions
Of course, human beings cannot handle all these
changes on their own. But through “foresight, ingenuity and effort,” as the FAA
describes it, humans have developed tools to help them deal with these changes,
such as pressurized flight cabins and temperature control.
Flight nurses that
travel with patients are experts in the following areas, which the FAA lists as
being some of the major areas of aviation physiological impact.
Pressure
As you move above sea
level and ascend into the sky, the air becomes less dense and there is
atmospheric pressure. Gas may expand as molecules travel farther apart – which
is why you might experience “trapped gas” issues in the ear canal or sinuses.
Artificial pressurization deals with most of these issues, but during ascent
people may feel the drop in pressure more acutely.
Respiratory and
Circulation
The human body has
amazingly simple, efficient respiratory and circulatory systems. The drop in
pressure, however, can impact them, potentially causing dizziness, headaches,
shortness of brief or fatigue. Again, this is something that cabin
pressurization helps to solve. However, a flight nurse traveling with a patient
is aware of these potential issues and prepared to deal with them if needed.
Hypoxia
A very dangerous
condition in which the oxygen supply to the lungs or other important organs is
inhibited. This is why a plane offers oxygen masks in case of sudden drops in
pressure or changes in altitude. Nurses also will carry oxygen for certain
patients and administer it, as needed, if signs of hypoxia occur.
Hyperventilation
This happens with people on the ground, but also is something to watch for while in flight. It simply means breathing at a fast, shallow rate that could inhibit the flow of oxygen through the body. This is sometimes brought on by anxiety or fear, which causes breathing to be controlled by emotions rather than by chemicals in the body. It can lead to a drop in carbon dioxide levels, which is dangerous if it continues for too long. Symptoms include dizziness, a tingling sensation, blurry vision and twitching muscles. These are just some of the issues that those with expertise in aviation physiology know how to handle during commercial flight medical transportation. It’s also the reason why an increasing number of people are turning to flight nurses to travel with them for non-emergency medical transport – allowing them to relax, knowing they have an expert in aviation physiology sitting beside them.
Interview with Up Close and PersonalJanuary 15, 2019 Bob Bacheler, MSN, CCRN, CFRN, CDP, Managing Director, #FlyingAngels, is now uploaded with many other interviews to UpCloseAndPersonalTV on YouTube. After over 25 years as a Critical Care Nurse, 12 years as a flight...
People use a long distance ambulance to transport themselves or a loved one in non-emergency situations. This medical transportation option ensures patients travel safely by either ground-based transport or commercial air travel.
The main goal in using a long distance ambulance and non-emergency medical transport is to ensure the patient has medical attention during their journey and arrives safely at their destination.
Often, those being transferred are seniors traveling to or from an assisted living facility, cancer treatment center, nursing home or home healthcare facility. They may also have been discharged in stable condition from a top US hospital and simply need to return home.
Using non-emergency medical transport (NEMT) is a popular medical transportation option. While it can involve the use of a long distance ambulance, it often involves commercial airline travel, accompanied by an experienced flight nurse.
A trip is generally considered to be long distance if it is more than 200 miles. As the nation’s population ages, there are an increasing number of non-ambulatory patients who require non-emergency transportation.
People use medical transportation for a variety
of reasons. They include:
Senior travelers taking a vacation or making a trip to see family
Those injured while on vacation who are coming back home
Patients transferring from one medical facility to another
Travelers with a disability or chronic condition that impedes movement
Seniors who are moving to a new area
Frequent medical conditions for NEMT patients include; Alzheimer’s, cancer, dementia, stabilized bone fractures, post-operative patients and those who are wheelchair-bound.
Those are just some of the scenarios that have made NEMT and long distance ambulances a more popular medical transport option in recent years.
NEMT companies such as Flying Angels can book a
flight for patients, coordinate with the airlines and airports along the route,
handle international flights and provide an experienced RN as a flight nurse.
That level of service makes air transportation a
great choice for many people. Transportation on a commercial airline also means
patients reach their destination faster than if they use ground transportation.
Even in a non-emergency situation, this is what most patients prefer.
Using a commercial flight with a nurse is also far less expensive than using an air ambulance, which is the most expensive transportation option. Whatever method you choose, it’s important to know that patients have options when it comes to medical transportation. With the modern services available, patients can quickly and safely reach their destination while enjoying the most comfortable situation possible.
