Development of prehospital medical classification criteria

INTRODUCTION: A trauma classification system (TCS) is widely used by many prehospital personnel to provide advanced activation of trauma teams. Specific criteria serve to notify specialty departments and enhance communication between prehospital and emergency department (ED) personnel. Because the TCS has worked so well, a medical classification criteria tool (MCCT) was developed to consistently notify EDs of medical patients' acuity, enhance communication, and provide a smooth transfer of care. METHOD: MCCT development included establishment of tool validity by experts; retrospective chart review to determine consistency and accuracy of classification; and a pilot test of the MCCT at three hospitals. After the pilot, satisfaction surveys were distributed to receiving hospitals to determine tool effectiveness, ease of use, and enhanced transition of care. RESULTS: Of the receiving staff surveyed, 97% found the tool easy to understand; 82% thought the MCCT enabled them to effectively prepare for patients; 62% perceived consistency in classification by the helicopter staff. The flight crew had a 100% positive response regarding ease of MCCT use; 36% noted a positive change in preparation for medical patients' transfer of care. CONCLUSION: The MCCT enhances communication and is useful in preparation and transition of patient care from prehospital to the hospital environment. Advanced notification of patient illness severity may enhance care and affect overall outcome.