Quicker team launch times for urgent priority neonatal retrievals: A Quality Improvement Initiative study
Authors: Desai Saumil A , George Kevin , McDonald Kylie , Timoney Alysha , Kelland Dahna , Barr Stephanie , Carroll Molly , Lockhart David , Peters Olivia , Davis Jonathan 
Published: October 2024

Background

Neonatal retrieval networks developed time-centric quality metrics as Key Performance Indicators (KPI) for benchmarking recently. Quicker launch time (departure from base), an essential KPI, enables neonatal retrieval teams to rapidly provide higher-level care to sick infants. Newborn Emergency Transport Services, Western Australia (NETS WA) facilitates neonatal transfers across largest global retrieval area necessitating quicker team launch times for urgent retrievals. NETS WA conducted Quality Improvement (QI) study to quicken team launch times for urgent priority retrievals.

Aims

Smart aim was to quicken NETS WA team launch times on urgent priority retrievals to ≤15 minutes (Australian New Zealand Neonatal Retrieval Network 2022). Secondary aims included impact of quicker launch times on time-centric quality metrics (“first look time”, “total retrieval time”).

Settings

This study was completed over two years by NETS WA. Urgent priority retrievals comprise 10-15% of total transfers (∼1200/year).

Interventions

QI team introduced Plan-Do-Study-Action (PDSA) cycles: 1. immediate access to transport cots 2. additional personnel 3. pre-defined priority matrix 4. direct communication strategies. Quality metrics (launch time, first look time, total retrieval time) were gathered from electronic retrieval database (REDCap). Data collection done at baseline (January-May 2022), during PDSA cycles (June 2022-April 2023) and post last PDSA cycle (May-December 2023).

Results

Launch times reduced from median (IQR) duration of 35.5 (21.5-90.0) to 17.0 (11.0-37.0) minutes for all urgent priority retrievals (p 0.0006). Launch times for road only urgent retrievals reduced to the recommended median (IQR) duration of 15.0 (10.0-20.0) minutes (p 0.009). Quicker launch times reduced first look time from median (IQR) of 85.0 (54.8-269.3) to 52.5 (30.5-152.3) minutes (p 0.008). Total retrieval time reduced from median (IQR) of 243.5 (135.8-395.3) to 182.0 (117.0-390.0) minutes (p 0.33).

Conclusion

Well-designed QI measures enabled NETS WA teams to quicken essential time-centric quality metrics for urgent priority neonatal retrievals.

What is already known on this topic

Quicker launch times are crucial for retrieval teams for rapid access provision of higher-level care to sick neonatal infants.

There is dearth of literature on measures to reduce launch times of neonatal retrieval teams.

What this study adds:

Newborn Emergency Transport Services Western Australia (NETS WA) Quality Improvement (QI) measures quickened team launch times on urgent priority neonatal retrievals.

Quicker launch times improved other essential time-centric quality metrics (“first look time” and “total retrieval time”) for urgent priority neonatal retrievals.

How this study might affect research, practice or policy:

The study provides data for consensus-based time-centric quality metrics for national and international benchmarking.

Generalizable study QI measures for other neonatal retrieval teams to adopt and reduce their launch times.