January 29, 2010

New system streamlines ambulance discharge process

Featured Image

Moses Jefferies gets ready to transport patient Lynda Hamman from Vanderbilt to Monteagle, Tenn. (photo by Anne Rayner)

New system streamlines ambulance discharge process

A new discharge system for patients leaving by ambulance is making the process more efficient and allowing Vanderbilt University Medical Center to collect valuable data.

The Discharge Transportation Management system (DTM) will now serve as the interface between staff and ambulance services.

To arrange a patient transport, call 2-RIDE and provide the following information: patient name, medical record number, patient weight, room number, major complications, special needs such as oxygen or infection precautions, and insurance provider.

DTM will then contact one of six rotating ambulance services and schedule the transport. Callers will receive a page with information on which ambulance is coming and its arrival time. A medical necessity form will be sent via e-mail.

DTM is staffed 24 hours a day. Although social workers, case managers and discharge planners will use the service the most, it will take calls from any VUMC staff member.

“We want all calls to go through Discharge Transportation Management, not because we're trying to build an empire but because we're trying to make jobs easier,” said Brent Lemonds, M.S., R.N., administrative director of emergency services.

“I know we have a lot of reasons why people can't get out of the hospital in a timely manner, but I don't want one to be because of ambulance service.”

In addition to scheduling the transport, DTM can manage insurance preauthorization and gather out-of-pocket transport quotes.

“The goal is to make jobs easier and get patients out of the hospital faster,” said David Russell, E.M.T.-P., discharge transport coordinator. “Previously, it was very disorganized. There would be 65 different people calling the ambulance service companies requesting a transport, often all calling the same one and overwhelming them.”

DTM has a computer dashboard to manage requests and track ambulance arrivals. It is constantly monitored, and staff will follow up when an ambulance is late.

With all calls going through DTM, VUMC is able to collect data on ambulance transport for the first time. Since the service rolled out in November, the data show the busiest days are Monday and Thursday and the busiest time is 11 a.m.

Ambulance services have already reacted to the data. One has hired a dedicated dispatcher for Vanderbilt and another added three more ambulances at peak hours.

“Now Vanderbilt, rather than the ambulance services, is in control,” Russell said. “If they are frequently late or provide inadequate service, we have the data to prove it. We can demand better service from them or drop their service from our rotation.”

There will also be significant cost savings because DTM is able to shop around for the best price.

Trauma Case Managers Brenda Reed, M.S.N., R.N., and Joy Bridgman, R.N., call DTM a “one-stop shop” for discharge transport needs.

“Prior to the Discharge Transportation Management program, it could be very time consuming to arrange ambulance transports,” Reed said. “The new system allows for less time on the phone with ambulance companies and more time spent with patients and families.”