Logistics and communication: Improving the transfer of patients with high consequence infectious disease.

Dr Su-yin Hor1, Dr  Mary Wyer3,5, Ms Ruth Barratt3, Dr  Kavita Varshney5, Ms  Kate Hipsley4, Dr Hamish Carver4, Ms  Cara Ashcroft4, Prof Lyn Gilbert2,3

1University Of Technology, Sydney, Broadway, Australia, 2Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney, Australia, 3Westmead Institute for Medical Research, Westmead, Australia, 4NSW Ambulance, Rozelle, Australia, 5Westmead Hospital, Western Sydney Local Health District, Westmead, Australia

Introduction: The emergence of COVID-19 globally and in Australia has highlighted ongoing challenges for identifying and managing patients with suspected high consequences infectious diseases (HCID). Recent changes in HCID training and policy are being tested in one Local Health District in NSW, in a series of simulated exercises. This presentation reports on the role of the ambulance service in one such exercise.

Methods: A simulated exercise involving an ED presentation and subsequent inter-facility transfer of a (volunteer) ‘patient’ with suspected COVID-19 between two hospitals in NSW was video-recorded in June 2020. This footage was reviewed and analysed by participants involved in the exercise and their colleagues in collaborative group reflexive sessions facilitated by researchers. The sessions were designed to explore the complexity of transferring a patient with a HCID between hospitals. The aims were to identify good practice, highlight challenges, and design system improvements. Three reflexive sessions have been conducted involving participants from the ambulance service, as well as emergency doctors and nurses, the counter disaster unit, and the volunteer ‘patient’.

Results: Preliminary analysis of the reflexive discussions relating to the inter-facility ambulance transfer identified three overlapping themes relating to good practice and challenges: infection prevention and control, logistics, and communication. Several solutions were proposed, with one currently being prototyped for implementation into practice.

Conclusion: The safe ambulance transfer of patients with suspected HCID relies not only on good infection prevention practices but also logistical planning and communication that is attentive and adequate to the needs of all parties involved.


Su-yin Hor is a social scientist and lecturer in Health Services Management at the University of Technology, Sydney. She specialises in patient safety and collaborative learning in acute care settings. Her current research uses participatory video-reflexive methods with healthcare staff and patients to improve infection prevention and control practices at the frontline of clinical care.