President’s message


President's Message. 
Winter 2022 – Rural Patient Transfer



Dr. Gabe Woollam
MD, CCFP, FCFP, FRRMS
Happy Valley Goose Bay, NL

Correspondence to:
SRPC President
Email

The CJRM
V27(1) Winter 2022

***

President's message.  Rural Patient Transfer

Message du président.  Transferts de patients en milieu rural

Early in my career, I remember sitting in a remote northern emergency room in the early hours of the morning with a hypotensive, bradycardic patient. I worked to stabilise him, then called Cardiology in the referral centre located 2 h by air to the south. The cardiologist asked, “How do you know this is a cardiac problem?” Frustrated but undeterred, I spent the hours that followed racing to find an accepting physician and arrange a medevac. As a sole physician in the hospital, I should have been providing patient care.

What seemed like an isolated experience at the time, I now see clearly as a widespread problem: many of the medical transport systems in this country are broken. Agreements and policy between sending and accepting sites are lacking, transport programmes are frequently under-resourced and inter-jurisdictional transfers can be impossible to navigate.

The burdens of these inadequacies are borne first not only by patients and communities but also by providers and health systems. Existing infrastructure often leaves patients waiting in underserved areas for too long and causes stress for patients, families, and transferring physicians[1] and may lead to increased mortality.[2]

However, there are things we can do. In April 2021, the Rural Road Map Implementation Committee (RRMIC) released their recommendations for improving patient transfer.[3] These included the following calls to action:

  1. Adopt formal patient transfer agreements
  2. Implement no-refusal policies
  3. Create supportive intra- and inter-jurisdictional infrastructures
  4. Leverage the use of virtual care technologies to support more care close to home
  5. Use data to evaluate, improve and reduce the need for patient transfers and enable on-going end-to-end planning.

The Society of Rural Physicians of Canada is pushing these recommendations forward through research, advocacy and collaboration with our RRMIC partners. I encourage each of you to find ways to be part of this collective effort in your respective corner of the country and to help realise these calls to action.

References

1.

Wilson MM, Devasahayam AJ, Pollock NJ, Dubrowski A, Renouf T. Rural family physician perspectives on communication with urban specialists: A qualitative study. BMJ Open 2021;11:e043470.  
    

2.

Moon J, Pop C, Talaat M, Boulanger N, Perron PA, Deckelbaum D, et al. Trauma in Northern Quebec, 2005-2014: Epidemiologic features, transfers and patient outcomes. Can J Surg 2021;64:E527-33.  
    

3.

Rural Road Map Implementation Committee. Call to Action: An Approach to Patient Transfers for Those Living in Rural and Remote Communities in Canada. Mississauga, ON: College of Family Physicians of Canada and the Society of Rural Physicians of Canada; 2021.  



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