Original Title: Processus de régulation et de priorisation clinique pour le déploiement optimal d’un système de transport médical héliporté au Québec

Authors' objectives: As part of the second phase of the project, INESSS undertook defining guidelines for regulation and clinical prioritization processes that would support the optimal and efficient deployment of HEMT as a mode of interfacility transfer within Québec’s emergency medical transport system.

Authors' results and conclusions: RESULTS (#1 DECISION-SUPPORT TOOLS): Four decision-support tools were developed to identify patients with time-sensitive presentations in trauma care, neurology, cardiology, and pediatrics who might benefit from helicopter transfer. These tools will enable the following: 1. To recognize the type of suspected time-sensitive condition during prehospital care; 2. To assess the severity of the suspected condition upon arrival at the nearest emergency department according to specific clinical criteria; 3. To initiate a HEMT transfer request if the severity level is confirmed, in accordance with established stabilization procedures; 4. To coordinate the transfer, via the medical regulation centre for helicopter transport, to the receiving centre according to the required care and regional organization, the operational modalities to be defined by the future organizational model of Québec’s Aeromedical Evacuation Centre (EVAQ). (#2 QUALITY INDICATORS): The literature review identified best practice guidelines and 36 potential indicators to evaluate the quality of care and services provided by helicopter transport. From this list, the advisory committee selected 32 indicators based on their relevance, acceptability, and feasibility of implementation as follows: • 26 indicators classified by the stage of the operational coordination process for HEMT transfers adapted from the literature; • 5 indicators specific to the time-sensitive conditions of interest; • 1 post-transfer quality indicator. Further work will be required to finalize, validate, and implement these indicators. CONCLUSIONS: The literature analysis and extensive consultation with key stakeholders from MSSS, EVAQ, and healthcare professionals have provided better understanding of the operational, organizational, and clinical challenges of deploying a HEMT service in Québec. This work also highlighted the importance of rigorous interfacility coordination, optimal resource management, and a patient-centered approach.

Authors' methods: To gather information on existing organizational models for HEMT transfers, targeted consultations were held with critical care health professionals and key HEMT organizations in Ontario and Alberta. The development of decision-support tools specifying prioritization guidelines for interfacility transfers by HEMT for the patient groups identified in Phase 1 was carried out with the support of an advisory committee composed of emergency services clinicians and managers. Quality indicators for evaluating care and services were identified using an adapted Delphi method to preselect 36 indicators found in the literature.

Project Status: Completed

Year Published: 2025

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Traumatologie/Transport_medical_heliporte_GN_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)