​What is the Transfer of Care Reporting System?

It’s a centralised, web based application that allows you to view your hospital’s Ambulance ‘Transfer of Care’ time any time of the day or night. It is the first system in NSW Health that allows for matching of Ambulance and ED data. This system has enormous
potential for future research, especially in trauma.

‘Transfer of Care’ – a new measure

‘Transfer of Care’ time is a new measure that is replacing ‘off stretcher’ time. It is captured using:

• ASNSW Ambulance arrival time as the start time
• to facilitate Transfer of Care, a clinical handover using a structured approach such as ‘IMIST AMBO’ must occur between the treating Paramedic and accepting ED clinician
• Transfer of Care is deemed complete when clinical handover has occurred and the patient has been offloaded from the ambulance stretcher and/or the care of the ambulance paramedics is no longer required.

Logging on to the Tra​​​nsfer of Care Reporting System

There should be a direct link to the login page on your intranet page. If not the login URL is Transfer of Care Reporting System.

Every hospital and every local health district have their own generic login details. If you forget your login details and password click on the ‘Forgot Password’ icon and it will be emailed to you.

How the Transfer of Care Reporting System works

The system uses the Ambulance Incident Number (handwritten sheet) or Case number (on the EMR print out) and date to match patients from the ambulance service with patients in the ED.

What do Emergency Department staff need to do?

1. Enter Ambulance Incident Number (handwritten sheet) or Case number (on the EMR print out) into your ED system (full patient registration screen).
2. Correct ‘unmatched patients’ and check the ‘error report’. Each hospital will decide who will be responsible for this. It is recommended that this is done on a daily basis

What do Ambulance paramedics need to do?

1. Paramedics are required to legibly write ‘incident number’ on hand written case sheets and communicate “incident number” (or Case number) at all communication points within EDs i.e. triage, ED clerk, patient handover, etc.
2. Paramedics are still required to press the "Off Stretcher" button on the ambulance mobile data terminal

Incident number location: The Ambulance ‘Incident Number’ is the 5‐digit, handwritten number located on the top of the Ambulance Case Sheet or the Case number on the EMR print out. It also appears on the Ambulance Status Board in your ED.

Why are Ambulance Incident numbers used?

At the present point in time, date in combination with Ambulance Incident Number/Case number is the only unique identifier of patients across both systems.

Using the Transfer of Care Reporting System

There are 3 links for you to access: ‘Home’, ‘Reports’ and ‘Help Desk’. Each link has a brief explanation of what its for and what it will produce.

Changing information in the Transfer of Care Reporting System

The Transfer of Care Reporting System only allows you to view information. Information you are viewing can only be changed at its original source. This means that if an incident number/case number is incorrect you will need to correct it within the ED System. Ambulance electronically generates true and accurate incident numbers.

Timeliness of Information in the Transfer of Care Reporting System

This system allows you to view yesterdays data. This is because it operates via daily batched data extraction. Which means that daily data is taken from both the ambulance and ED systems and matched within the Transfer of Care Reporting System once a day (approximately 5am for the previous day’s data).

Most frequently used reports

The KPI report:

• Total ambulance arrivals
• Percent patients with care transferred from paramedic to an ED clinician within 30min (ToC KPI) , 1hr, 2hrs, 3hrs and >3hrs

Summary report:
Summarises your information by triage category i.e. ambulance arrivals, ToC KPI, unmatched patients

Daily validation of information is recommended

• The ‘Unmatched Patient Report’ alerts you to patients from both ambulance and ED that are not able to be matched. Most of the time this is due to incorrect entry of incident number/case number into your ED system. It is recommended to use this report daily to locate the right incident number/case number and enter it into your ED system.
• The ‘Error Report’ alerts you to when something unusual has occurred with matched patients e.g. ambulance arrival time is after ED registration time , ambulance left before transfer of care time

Note: We also recommend keeping an electronic copy of these reports for future reference.

How does Incident Number/Case number get entered into our ED System?

The Incident Number/Case number is set up to be entered in the full ED patient registration screen, after ambulance arrival mode has been selected. At most hospitals it is generally the ED clerical staff who will do this. NOTE: Patient care is the priority of the triage nurse and ED clinicians.

What happens if an Incident Number is entered incorrectly?

If this occurs patients are not able to be matched and ‘Transfer of Care’ time will automatically default to the ambulance ‘Off Stretcher time’. Once the incident number is entered correctly (in the ED system) it will appear as matched the following day.

What happens when two patients arrive in the one ambulance?

This scenario occurs extremely infrequently. Two patients in one ambulance will only produce a single incident number. The data from the first patient will be linked in the system to produce Transfer of Care Time. Because the Transfer of Care Reporting System is a statistical recording system of ‘Percent patients transferred from an ambulance paramedic to an ED clinician within 30min’, it has been shown not to be significantly impacted by these events.

Alerts that appear in the ‘Error Report’

• Patient Registration is before ambulance arrival time.
• Ambulance leaving time prior to Transfer of Care.
• The Ambulance Facility Code differs from the ED Facility Code.
• Missing Time of Ambulance Delayed Available (i.e. end point of ambulance OST).
• Patient registered more than 2 hours after ambulance arrival.
• Missing Time Leaving Ambulance Location (i.e. End point of Transfer of Care time).

Note: Patients appearing in the error report may still have all information as correct, this could be due to something highly unusual occurring during their stay.

Further information

The TCRS User Guide is available on the Home Page of the Transfer of Care Reporting System.​