Optimal Interhospital Transport Systems for the Critically III

Increasingly, critically ill patients are undergoing interhospital transportation. The reason for transport is not only for higher level care, but also as consequences of the re-distribution of critical care resources. There are many transport system issues for such patients. These issues have the potential for significant patient and transport team morbidity and financial burden upon the health services. An examination of events during the patient referral process can identify referral system based problems at many levels of health care. This chapter will review our current knowledge of the clinical and operational process for referral and transportation of critically ill adult patients as well as the available means of its evaluation and likely future direction.