Subject Policy on Ambulance Service

							      Health Authority - Abu Dhabi                                  ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                       Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                       Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                       Revision Date: May 2009

                                                       Version: I

1. PURPOSE
    To guide and facilitate the health care providers on the standards of safe, efficient and timely
    transportation of a patient from one health care facility to another designated health care
    facility by the ambulance service.

2. POLICY STATEMENT
    Health authority Abu Dhabi (HAAD) mandates that while transporting the patient who requires
    ambulance service the following steps must be adopted by each and every Health Care Facility
    (HCF):

    2.1. All HCFs/ providers must identify the appropriate ambulance service available in the
         locality with their complete address and contact numbers available, and ensure that an
         ambulance (vehicle) is designed and is appropriately equipped as per ambulance
         standards to respond to medical emergencies.

    2.2. Each health care facility should have a designated person from the facility who will
         coordinate this service effectively and ensure the timely transportation of the patients by
         ambulance in case of emergency.

    2.3. The ambulance service contact numbers should be displayed in front of the reception
         counter as well as other appropriate locations in the facility and is visible.

    2.4. The ambulance service should be available or reach the HCF within the time frame as per
         international standard (The most critical emergency calls, referred to as "Category A"
         calls, have a response time requirement of eight minutes and zero seconds, with a 75%
         compliance requirement, and the additional stipulation that 95% of these calls must be
         reached within 14 minutes in urban areas and 19 minutes in rural areas Non-life-
         threatening calls have an established target of 14 [urban] and 19 [rural] minutes without
         response time compliance percentage requirements).




Reviewed by: Joint Commission International                                                      Page 1 of 6
      Health Authority - Abu Dhabi                                  ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                       Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                       Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                       Revision Date: May 2009

                                                       Version: I

    2.5. The physician/consultant of the referring/transporting HCF would be responsible to
         assess/establish the need for the patient to be transferred through an ambulance.

    2.6. The referring HCFs must identify the appropriate health care facility before the patient is
         transported by an ambulance service (all steps have to be met for referring patient as per
         the HAAD Referral Policy Ref 001/07).

    2.7. Complete documentation (through file) which includes the treatment that was given to
         the patient from the referring/transporting HCF including demographic data of patient,
         diagnosis, reason for referral, medications administered, diagnostic test results, and all
         available procedural and therapeutic interventions must accompany with
         patient/guardian/relative/paramedic staff while transporting the patient through an
         ambulance.

    2.8. Qualified clinical / paramedical staff from referring HCF must accompany the patient in
         an ambulance while transportation to the receiving facility.

    2.9. It is the responsibility of management and staff of the referring/transporting HCF to
         check that the ambulance is well equipped and all equipments are functional to respond
         to medical emergencies during the patient transportation.

    2.10. The referring HCF management will be responsible for any delay (if happened) in
          transporting the patient to the referred health care facility.

    2.11. After each patient transfer by ambulance, it is the responsibility of ambulance service
          provider to dispose of all used disposable and contaminated items and replace them with
          new. All other items including emergency medicines should also be refurbished.

    2.12. If the HCFs do not have their own ambulance or ambulance service contract with the
          third party then they may call police ambulance service- universal access no: 999, for
          transporting of patients in Emirates of Abu Dhabi. The complete address regarding the
          location of referring HCF, demographic data of patient, his/her illness and the complete




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      Health Authority - Abu Dhabi                                   ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                        Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                        Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                        Revision Date: May 2009

                                                        Version: I

           address of referral HCF must be properly communicated to the staff of that ambulance
           service.

3. SCOPE
    This policy will be applicable to all HCFs (Public & Private) in Emirate of Abu Dhabi.

4. TARGET AUDIENCE
    All health care providers and staff

5. RESPONSIBILITY
    The management of the referring/transporting HCF will be responsible for the safe
    transportation of patient through an ambulance.

6. PROCEDURE
    6.1. Physician attending the patient of referring HCF will assess the need for
         transportation of patient through an ambulance to the referred health care facility.

    6.2. Designated staff at the HCF will immediately start the process as per the facility protocol
         to arrange for an ambulance for safe and efficient transportation of the patient to the
         referred facility.

    6.3. Timely arrangement and availability of the appropriate ambulance services as per
         international standard will be established by the person responsible at the referring
         facility.

    6.4. The health care provider must stabilize the patient and ensure that the treatment given to
         the patient at the facility is fully documented and signed. The necessary document (file)
         must accompany the patient at the time of transportation to the referred facility.




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      Health Authority - Abu Dhabi                                           ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                                Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                                Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                                Revision Date: May 2009

                                                                Version: I


    6.5. The referring physician will also ensure that the ambulance (vehicle) is designed and
         equipped to respond to medical emergencies and as per need of the patient.

    6.6. Before transporting the patient, it is the responsibility of referring HCF to complete the
         appropriate communication regarding the referral of patient to the receiving hospital.

    6.7. Designated clinical staff will accompany the patient during the transfer and record in the
         patient file all care and treatment administered during transfer. The names individuals
         accompanying the patient will be recorded in the patient file.

7. DEFINITIONS

Ambulance                                     The term ambulance is most commonly associated with the
                                              land based, motorized emergency vehicles seen throughout
                                              the world administering emergency care to those with acute
                                              illnesses or injuries, hereafter known as emergency
                                              ambulances. These are usually fitted with flashing warning
                                              lights and sirens in order to facilitate their movement through
                                              heavy traffic.
                                              A vehicle which is equipped to assist patients in all aspects of
                                              care to ensure a smooth, safe and efficient transfer of the
                                              patient.
Ambulance Service                             The ambulance service provides the first point of access to
                                              health care for a wide variety of patient conditions, ranging
                                              from life-threatening emergencies to chronic illness and social
                                              care.
Appropriate Health Care                       Appropriate health care facilities means that those health
Facilities                                    facilities which are well equipped to provide the required
                                              treatment.
HCF                                           Health Care Facility




Reviewed by: Joint Commission International                                                               Page 4 of 6
      Health Authority - Abu Dhabi                               ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                    Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                    Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                    Revision Date: May 2009

                                                    Version: I

8. REFERENCES
    1. Wikipedia. Definitions of Ambulance. Available at
       http://en.wikipedia.org/wiki/Ambulance. Accessed 27, January 2007.

    2. Government of British Columbia: Ministry of Health. Overview of the British Columbia
       Ambulance Service. Available at http://www.healthservices.gov.bc.ca/bcas/overview/.
       Accessed 27, January 2007.

    3. Idaho Board of Health & Welfare. Minimum Equipment Standards for Licensed EMS
       Services. Version 3.0. Available at http://www.healthandwelfare.idaho.gov/. Accessed 27,
       January 2007.

    4. Silverman RA, Galea S, Blaney S. "Vertical response time: The hidden component of
       ambulance response time." Academic Emergency Medicine. Available at
       www.aemj.org/cgi/content/abstract/12/5_suppl_1/142. Accessed March 2007


    5. Fitch, Jay. “Response Times: Myths, Measurement and Management”. JEMS 2005; Vol.
       30. Available at www.jems.com/paramedics/ch1e.html. Accessed March 2007.




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      Health Authority - Abu Dhabi                                ‫هــﻴﺌـــــﺔ اﻟﺼﺤﺔ - أﺑﻮﻇﺒﻲ‬


                                                     Reference Number: PPR/HCP/P0006/07
Division/ Department/Section: PPR/HCP
                                                     Issue Date: May 2007
Subject: Policy on Ambulance Service
                                                     Revision Date: May 2009

                                                     Version: I

9. APPENDIX I
    Minimum Equipment Standards for a Licensed Ambulance Service:

    1. Any vehicle used as an ambulance must be designed and equipped to respond to medical
       emergencies and, in non emergency situations, be capable of transporting beneficiaries
       with acute medical conditions.

    2. The vehicle must comply with state or local laws governing the licensing and certification
       of an emergency medical transportation vehicle.

    3. At a minimum, the ambulance must contain a stretcher, linens, emergency medical
       supplies, fixed and portable oxygen equipment, fixed and portable suction machine;
       Sphygmomanometer with different size of cuffs, stethoscope, sharp containers, disposable
       gloves, vomiting bags and intravenous administration sets and is equipped with emergency
       lights, sirens and telecommunication equipments as required.




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