Feasibility of the Transport PLUS intervention to improve the transitions of care for patients transported home by ambulance: a non-randomized pilot study

Kevin G. Munjal, Sai Kaushik Yeturu, Hugh H. Chapin, Nadir Tan, Diana Gregoriou, Daniela Garcia, Corita Grudzen, Ula Hwang, Barbara Morano, Hayley Neher, Ksenia Gorbenko, Glen Youngblood, Anjali Misra, Staley Dietrich, Cyndi Gonzalez, Giselle Appel, Erica Jacobs, Albert Siu, Lynne D. Richardson

Research output: Contribution to journalArticlepeer-review


Background: The growing population of patients over the age of 65 faces particular vulnerability following discharge after hospitalization or an emergency room visit. Specific areas of concern include a high risk for falls and poor comprehension of discharge instructions. Emergency medical technicians (EMTs), who frequently transport these patients home from the hospital, are uniquely positioned to aid in mitigating transition of care risks and are both trained and utilized to do so using the Transport PLUS intervention. Methods: Existing literature and focus groups of various stakeholders were utilized to develop two checklists: the fall safety assessment (FSA) and the discharge comprehension assessment (DCA). EMTs were trained to administer the intervention to eligible patients in the geriatric population. Using data from the checklists, follow-up phone calls, and electronic health records, we measured the presence of hazards, removal of hazards, the presence of discharge comprehension issues, and correction or reinforcement of comprehension. These results were validated during home visits by community health workers (CHWs). Feasibility outcomes included patient acceptance of the Transport PLUS intervention and accuracy of the EMT assessment. Qualitative feedback via focus groups was also obtained. Clinical outcomes measured included 3-day and 30-day readmission or ED revisit. Results: One-hundred three EMTs were trained to administer the intervention and participated in 439 patient encounters. The intervention was determined to be feasible, and patients were highly amenable to the intervention, as evidenced by a 92% and 74% acceptance rate of the DCA and FSA, respectively. The majority of patients also reported that they found the intervention helpful (90%) and self-reported removing 40% of fall hazards; 85% of such changes were validated by CHWs. Readmission/revisit rates are also reported. Conclusions: The Transport PLUS intervention is a feasible, easily implemented tool in preventative community paramedicine with high levels of patient acceptance. Further study is merited to determine the effectiveness of the intervention in reducing rates of readmission or revisit. A randomized control trial has since begun utilizing the knowledge gained within this study.

Original languageEnglish
Article number169
JournalPilot and Feasibility Studies
Issue number1
StatePublished - Dec 2022


  • Community paramedicine
  • Discharge comprehension
  • Emergency medical services
  • Emergency medical technicians
  • Fall safety
  • Mobile integrated healthcare
  • Prehospital care
  • Readmissions
  • Transitions of care


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