2.3.d Procedures for Transfers
Procedures for Home Birth Transfer
Established Transfer Plans can improve outcomes and the experiences of all involved. Transfer Plans are arrangements put in place prior to the onset of labour to ensure smooth and safe transitions across levels of care. They may include verbal and/or written agreements across providers, staff at facilities, and the people who receive care.
- An intrapartum, postpartum, or neonatal indication for transfer arises and triggers an shared decision making conversation about risks and benefits of moving into hospital.
- Person and family agree to transfer.
- Decision made regarding method of transport. Either a personal vehicle or call Emergency Medical Services (EMS). The mode of transport may depend on reason for transfer, such as urgency, proximity to hospital, stage of labour/birth, need for continuous care enroute, costs for and availability of transport vehicle, weather conditions, family's ability/desire to operate vehicle, etc.
- Primary Provider at home calls hospital staff to notify them of reasons for transfer and timing of incoming transfer. This may or may not also include a phone consultation with a consultant, using an SBAR to convey information.
- Assist with preparing for transfer while continuing to monitor the client and the baby. Preparations may include gathering supplies for staying overnight in hospital, for admission to hospital, or arrange for at home sibling care.
- Verbally prepare family with information about what will happen when a transport team arrives, and enroute to the hospital. Outline procedures to expect upon arrival at the hospital.
- If the Primary Provider is travelling with the client for transport, gather an Emergency Birth Kit and copy of medical records. The kit will include items not available in EMS vehicle.
- When EMS arrives Primary Provider identifies themselves and the client, and provides a verbal handover, or SBAR, to the EMS team on the relevant aspects of the situation.
- Redistribute responsibilities between all health care providers in the home, as necessary. While in ambulance, the Primary Provider manages ongoing care to the client and baby.
- If the Primary Provider is transferring to the hospital in parallel vehicle to the client, collect all supplies necessary for care in hospital. For example blood samples, placenta and the documentation.
- Upon arrival at hospital, Primary Provider must give a verbal handover about the course of care to date to brief all multi-disciplinary team members, including charge nurse, labour nurse, Obstetrician, Anesthetist, and/or Pediatrician. An SBAR should be used individually with consultants who will be sharing care, or transferring care from the Primary Provider.
- Admit the person directly to hospital room and consult, or transfer to primary care consultant as appropriate.
- Document the reasons for transfer, arrival time, plan for ongoing care, and roles of each person involved in care. Ensure the client and family is clear about people's roles and involvement in care.