Safety & Security
Non-Emergency Transportation
Raises Safety, Liability Issues
Hospitals providing non-emergency transportation services, via a van or other vehicle, improve access to care for those in outlying communities and relieve stress for patients unable to drive themselves to outpatient surgery, testing or chemotherapy treatments. Long-term care facilities, too, assist patients in reaching physician offices and completing vital errands. Transportation can be an invaluable patient service, but driver hiring and training, Americans with Disabilities Act (ADA) compliance and timely vehicle maintenance are among the issues requiring close attention by facilities that offer it.
Follow usual hiring guidelines
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) human resources standards apply to patient services personnel, which include transportation drivers regardless of whether they are direct employees or working under contract for another organization.
Accordingly, facilities should verify:
- Receipt of proper training in accordance with any pertinent regulations as well as facility policy
- Evidence of experience and competence level appropriate for assigned responsibilities
- Possession of a valid driver’s license
- Completion of a criminal background check
- Validity of supplied references
- Health status, e.g., are there physical conditions (black outs, seizures) that will impair performance of responsibilities
You’ll also want to see evidence of an acceptable driving record; facility policy should state clearly which offenses are acceptable, i.e., parking tickets, and which are not. You may also want to require a minimum number of years of driving experience as a job prerequisite. A five-year minimum, for example, would ensure drivers are at least 21.
Develop a driver training program
Facilities must determine how drivers will be trained and what subjects training needs to cover. For starters, transportation drivers should know the area in which they’ll be driving extremely well, including locations of police stations and medical facilities. And complete familiarization with the vehicle is crucial, i.e., how to operate the mirrors, windshield wipers, brakes, doors and wheelchair lift, if there is one.
To maximize passenger safety, you should also make sure drivers know:
- Possible causes of passenger injuries – slips and falls, sudden stops – and steps to prevent them
- Seatbelt law/policy
- Basic first aid and CPR
- What to do in the event of passenger illness or an accident
- Procedure to follow in an emergency situation, such as a collision or fire
- Proper evacuation procedures
- Location of emergency exits and equipment
- What is and isn’t allowed in the vehicle in terms of personal devices, e.g., cell phones, radios and DVD players
Since it’s likely there will be passengers using wheelchairs, wheelchair-handling procedures should be clearly outlined and training in this area made mandatory for newly hired drivers. If children might accompany passengers, the vehicle must be equipped with car seats.
Design, inspections enhance patient safety
If you have a say in the vehicle’s internal design, keep in mind that visually impaired people find it easiest to distinguish colors in the yellow-red-orange spectrum. Also, use of bright, contrasting colors on the vehicle’s floor, seats and walls will facilitate safe movement, and good lighting will help prevent tripping or falling.
Other safety measures that will help prevent injury:
- Floors and step coverings made of non-skid materials
- Vehicle surfaces and floors cleaned regularly and inspected daily
- Regular inspection of seatbelts for wear or damage
- Handrails placed at proper heights and angles
- Mirrors large enough to provide driver a view of the full height and length of the vehicle, from its top to where tire meets the road
- Fire extinguisher, first aid kit, and flares on board at all times
It may also be prudent for the vehicles your facility is using to have:
- Safety interlock system, meaning the vehicle can’t be moved if a door is ajar, or the ignition key may be removed but the heat/air conditioning will keep working
- Master shut-off switches to be activated in an accident or if there’s potential for fire
- Fuel tank protection, minimizing puncture in an accident (school buses have this)
- Audible alarms to indicate when the vehicle is in reverse or preparing to back up
Complete inspection of the vehicle against a checklist at regular intervals should be in the driver’s job description. He or she should check steering, brakes, headlights, turn signals, mirrors, tire inflation and tread condition, fuel/hydraulic/cooling systems for leaks, door operation, horn, and wiper blades. Any identified maintenance issues should be communicated without delay.
Don’t ignore ADA requirements
ADA transit-related regulations apply to “any private entity that is not primarily engaged in the business of transporting people but operates a demand responsive or fixed route system.” Facilities making transportation services available must ensure vehicles are properly equipped and services are accessible by disabled persons.
Among the specific ADA policies:
- Individuals with disabilities may not be denied the opportunity to use a transportation service available to the general public
- Individuals with disabilities may not be required to use designated priority seating
- You may not require that individuals with disabilities be accompanied by an attendant
An overview of ADA policies should probably be included in your driver-training program. And, if your vehicle(s) has a lift, the ADA specifies that everyone operating it be trained in safe operation and proper maintenance, and that cycling of the lift be included in a daily inspection.
Related links
ADA home page:
http://www.ada.gov/
JCAHO homepage:
http://www.jcaho.org/