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When ED patients at Paradise Valley Hospital in National City, CA, needed transportation home, busy nurses typically handed out taxicab vouchers — a practice that cost the ED up to $1,200 per month, says Stephanie J. Baker, RN, BSN, CEN, MBA/HCM, director of emergency services.
The hospital had a van service already in place that the ED had used occasionally in the past, but the service was not timely. "The problem was that they had so many scheduled transports, they would take forever to accommodate us," she recalls.
Baker met with the director of the transportation service and determined that the van service could handle the ED’s patient transport needs, as long as patients were able to get in and out of the van themselves. "The drivers are not medical people and couldn’t take patients that needed [emergency medical technician]-level care," she says. "They are just providing transportation service and aren’t there to be medical personnel for them."
From the hours of 8 a.m. until 10 p.m., the van service dispatch center is called when a patient needs transportation home. "Within about 20 minutes, they call back and let us know how long the transport will take to pick the patient up, so the staff will know that if the wait is three hours, they need to work on getting alternate transportation," says Baker.
A brief information sheet is filled out for the van driver with the patient’s name, destination, and the time the pickup is expected, with ED staff ensuring that the patient gets on the van safely. Currently, the van transports 50-100 ED patients each month. "We went from $1,200 a month at our worst to normally less than $100 per month. I’ve never been over $200 since we put this process in place," she reports.
The van service also provides a safety net for patients who require assistance getting home, which reduces liability for the hospital, says Baker. "Is it safe to put a 65-year-old lady with an ankle fracture who we put on a walker on a bus, or even a cab, so she has to walk to the door and get in and not fall?" she asks.
In addition, if for some reason the patient can’t get into their home, the van service will bring the patient back, which a cab won’t necessarily do, she explains. "If it’s inappropriate to leave a patient, they won’t just drop them off," says Baker. "You have better peace of mind knowing that the patient is being transported with a certified driver who will make sure that the patient makes it safely home."
[Editor’s note: For more information, Baker can be reached at Paradise Valley Hospital, 2400 E. Fourth St., National City, CA 91950. Telephone: (619) 470-4386. E-mail: firstname.lastname@example.org.]