Challenges relating to the inter-facility transport of high acuity paediatric cases

The motivation for this study came from anecdotal reports and observations that there was a po- tential need for improvement to the systems that support inter-facility transfers of high acuity paediatric cases between referring and receiving facilities in Johannesburg, South Africa. In this exploratory study, we formally document and describe challenges being experienced by members of the healthcare team in facilitating the inter- facility transport of high acuity paediatric cases. Methods: A qualitative, explorative design was applied, making use of interviews with purposefully-identified role players involved in paediatric transportation and care. Verbatim transcripts from audio recorded interviews underwent content analysis to allow for the identification of common categories. Results: Participants described a number of challenges, which included time delays, lack of qualified ambulance personnel, poor communication between role players, and lack of appropriate equipment. Discussion: There are significant challenges experienced by members of the healthcare team with regard to inter- facility transport of high acuity paediatric and neonatal cases in Johannesburg, South Africa. Whilst we ac- knowledge the African context and resource constrained setting, health systems managers need to explore the feasibility of establishing dedicated and suitably resourced retrieval teams who specialise in the transfer of high acuity paediatric and neonatal patients in order to improve quality of care and overall patient outcomes in this population.