Requesting air ambulance transport of patients with suspected appendicitis: The decision-making process through the eyes of the rural clinician.
The Australian journal of rural health · 2022-12-21 · Qualitative study
Abstract
OBJECTIVE: The primary aim is to explore rural clinicians' self-reported knowledge, skills and attitudes in the decision-making process for requesting aeromedical retrieval of patients with suspected appendicitis. A secondary aim is to understand the supports and barriers of rural clinicians experience in this clinical scenario. SETTING: Clinician interviews conducted face-to-face in three rural hospitals in Central Queensland. PARTICIPANTS: Rural doctors and nurses. DESIGN: A five-part qualitative content analysis. RESULTS: The majority of 44 participants identified the strong and effective teamwork. The decision to request aeromedical retrieval was a shared, joint process and identified a supportive collegial culture which supported the asking of questions and not expecting to have all the answers. Perceived barriers were lack of receiving clinicians understanding of transfer agreements, and data connectivity. Clinician pessimism was identified for perceived patient outcomes. DISCUSSION: Effective teamwork can nurture trust and collaboration across multiple health service roles. High job satisfaction may counter the physical isolation in some rural environments. Fragmentation of care is the unintended consequence of interhospital transfer and may impact rural clinicians' perception of patients' outcomes and hinder receiving clinicians' understanding of rural service limitations. CONCLUSION: Future work in the area of linked electronic medical records could remove a barrier for rural clinicians and improve their reflective practice by challenging their perception of definitive patient outcomes. Increased awareness by receiving clinicians of the limitation of rural services, may minimize communication barriers and thereby, improve timely patient care transfers.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Communication & handover · Interfacility & critical care transport · Rural & remote · Teamwork & human factors
Related articles
- Air Medical Transport of Patients Diagnosed With Confirmed Coronavirus Disease 2019 Infection Undergoing Extracorporeal Membrane Oxygenation: A Case Review and Lessons Learned. (Air Med J, 2021)
- A regional partnership model for VA-ECMO initiation and transfer from remote centers using air medical transport. (Int J Artif Organs, 2026)
- The interdisciplinary team experiences of managing patient safety during a fixed-wing inter-hospital aeromedical transport: A qualitative study. (Int Emerg Nurs, 2021)
- Does the rural trauma team development course shorten the interval from trauma patient arrival to decision to transfer? (J Trauma, 2011)
- Where There Is No Trauma System: A Successful Patient Evacuation in the Republic of Kiribati. (Disaster Med Public Health Prep, 2019)
- Experience of physician and nurse specialists in Sweden undertaking long distance aeromedical transportation of critically ill patients: A qualitative study. (Int Emerg Nurs, 2019)