Safety and Speed – Arkansas Children’s Hospital Neonatal Transport
Safety and speed are hallmarks of the nationally-respected patient transport team at Arkansas Children’s Hospital, known as Angel One.
“Our average connection time between the time the referring hospital calls to speaking to an ICU physician (neonatologist or critical care doctor) is less than five minutes. We try to get the [Angel One] team out of this hospital and en route as fast as possible. We average less than 30 minutes for both pediatric and neonatal patients,” said, Franscesca Miquel-Verges, M.D., medical director of neonatal transport at Arkansas Children’s Hospital.
One Centralized Team Dedicated to Patient Transport
Miquel-Verges, also a professor of Pediatrics in the Division of Neonatology and division associate chief for clinical affairs at the University of Arkansas for Medical Sciences (UAMS), attributes the team's fast response times to the fact that every member of the team is employed by Arkansas Children's. Angel One includes 12 nurses, 11 EMTs, 11 respiratory therapists, 10 dispatchers, 6 mechanics, 11 pilots and a multi-disciplinary leadership team. It's a free-standing team, which means the providers are dedicated to patient transport and do not have to leave clinical assignments in the NICU or PICU when a call comes from a referring hospital.
"This model allows us to have quality improvement projects that cross specialties. When we get a call, the entire team is trying to get to that patient quickly. We're not waiting for somebody who's not here."
In FY2023, Angel One—with two state-of-the-art Sikorsky 76D helicopters and five ground ambulances—transported over 2,000 patients from Arkansas, Alabama, Florida, Missouri, Oklahoma, Tennessee and Texas.
Providing Care in Transit
Arkansas Children's Hospital is home to the state's only Level 4 NICU, but frequently care begins before the patient reaches the facility. The Angel One team often provides intensive care immediately upon arrival at the referring hospital and while transporting a patient. The transport units are outfitted with high frequency oscillatory ventilators, inhaled nitric oxide delivery systems, therapeutic devices and can provide mobile ECMO machines. Speed and those advanced technologies are essential for critically ill neonates with conditions such as pulmonary hypertension or hypoxic-ischemic encephalopathy (HIE).
Respiratory distress is the most common condition for neonates requiring transport, but other patients that warrant high-level transport include babies with congenital anomalies, sepsis or those experiencing deterioration due to underlying conditions.
The Angel One team is often called for threatened pre-term deliveries of extremely premature babies. "That makes us different from a lot of hospitals. Our team goes to the deliveries of a lot of premature babies or babies with congenital anomalies." Transporting the pregnant mother to a facility with a NICU happens if possible. When a mother cannot be transferred, the Angel One team assists in the birth, then provides care for the newborn and transports them to Arkansas Children's Hospital.
Angel One nurses and respiratory therapists are highly trained in neonatal and pediatric resuscitation techniques. Team members participate in simulations regularly and attend deliveries at partner hospital UAMS in order to keep their skills sharp and current.
Achieving Exceptional Outcomes
The combination of trained and experienced team members and leading-edge technology results in excellent outcomes. The Angel One team participates in Ground and Air Medical Quality in Transport (GAMUT), a national quality collaborative. The team has consistently proven to be a leader in pediatric transport. Their rate of successfully intubating neonatal and pediatric patients on the first attempt exceeds the national average.
“Our team does well with a lot of quality metrics, including tracking waveform capnography for mechanically ventilated patients and checking glucoses, but also cares for the family as a whole and almost always will transport a parent with a child,” Miquel-Verges said.
Arkansas Children's Hospital Angel One transport team is certified by the Commission on Accreditation of Medical Transport Systems (CAMTS), an organization dedicated to improving the quality of patient care and safety for the transport team. In addition, the team is involved in local as well as multicenter research trials and the medical directors are members of the American Academy of Pediatrics Section of Transport Medicine executive committee.
Arkansas Children's Hospital was the first hospital in the world to use the Olympic Medical Cool-Cap on an infant within hours of its FDA approval. Today, this technology is part of our multidisciplinary neonatal neurocritical care program.
The Arkansas Children’s Hospital (ACH) Neonatal Intensive Care Unit (NICU) has received a Gold-Level Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN).
