Patients are frequently transferred between hospitals to receive higher levels of care and specialty services. This is particularly prevalent in community hospitals and rural settings where such care is not always readily available. However, not all patients require emergency medical services (EMS) level of care or a stretcher for transport. Wait times for EMS interfacility transfers are often prolonged and EMS transport can be associated with significant costs. Utilizing Non-Ambulance Vehicle (NAV) for Interfacility Transport (NAVIT) offers an alternative that can reduce transfer delays for stable patients deemed appropriate for this mode of transport by the sending physician.

NAVIT has the potential to significantly reduce transfer times. Patients can wait up to three hours or more for EMS interfacility transport [1]. These types of delays can even affect critical patients. One study found that trauma patients with hypotension experienced an average wait time of 134 min at the sending facility for EMS arrival [2]. By utilizing NAVIT for appropriate stable patients, EMS resources could be prioritized for acute and critical cases, potentially reducing the burden on EMS systems and hospitals. Thus, NAVIT has the potential to improve overall efficiency in EMS systems and health systems, reduce cost and expedite patient transfers to definitive and higher levels of care.

Interfacility transport modes include non-ambulance (many times private, but sometimes public) vehicles and EMS via ambulance or air (helicopter or fixed wing). The American College of Emergency Physicians (ACEP) states in a position statement that the selection of transport mode should be at the discretion of the emergency physician, physician assistant, or nurse practitioner [3]. An analysis of the National Hospital Ambulatory Medical Care Survey found that from 2014 to 2017, 4.5 million emergency department encounters involved EMS interfacility transport [4]. This represents a large number of patients, where some could be deemed stable for NAVIT. When considering the impact of interfacility transport, cost must also be considered. EMS transport costs vary significantly by region and ambulance type, typically ranging from $200 to $1200 [5]. These costs may be restrictive for some patients, making NAVIT a safe and cost-effective alternative for patients deemed safe for this mode of transport.

Despite potential benefits, there is scarce current literature explicitly evaluating the safety of NAVIT. Existing data consist primarily of anecdotal evidence and case reports. This study aims to determine the prevalence of adverse patient outcomes during or immediately following NAVIT within a single integrated health system.