title: Transport services under stress: patient air transfers due to industrial action in Christchurch.
abstract: OBJECTIVE
  On 2 and 3 December 2001, widespread industrial action by nursing staff in the five public hospitals in Christchurch resulted in a minimal number of nurses being available for inpatient care. The major hospital affected was Christchurch Public Hospital. Mass transfer of patients (and relatives) occurred, by road to local, private nursing homes, and by air to hospitals throughout New Zealand. This caused disruption at both a local and national level. This paper discusses the process by which air transfers took place and the lessons learnt from the experience.
  
  
  METHODS
  The reduction of inpatient numbers in this tertiary referral hospital was necessary in anticipation of a full withdrawal of labour by the nursing staff. All patients identified as potentially transferable were individually assessed as to the risk of remaining in an understaffed hospital versus that of transfer. The Intensive Care Unit (ICU) coordinated the triage of patients and organised air transfers. All elective work was suspended. Following strike action, all patients transferred were returned to Christchurch as rapidly as possible.
  
  
  RESULTS
  Eighty four patients were identified for air transfer. Eight were unfit for transfer and, of the remainder, 43 were transferred with their relatives in a six-day period before the industrial action began. This required the services of all medical air transport facilities within New Zealand, placing the aeromedical retrieval services under considerable stress. The hospital was reduced to 20% capacity at strike commencement (from 650 beds to 148). Intensivists performed nursing duties in the ICU.
  
  
  CONCLUSIONS
  Two days of strike action resulted in 15 days of local and national disruption. Central coordination of all aero-medical transfer services, hospital teams, ambulance and social services was essential. The provision of 'family packages' was useful in assisting with the marked disruption experienced by patients and relatives.
authors.affiliation: Intensive Care Unit, Christchurch Hospital, Christchurch, New Zealand. peter.Dzendrowskyj@middlemore.co.nz
authors.forename: Peter
authors.initials: P
authors.lastname: Dzendrowskyj
authors.forename: David
authors.initials: D
authors.lastname: Bowie
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Shaw
mesh_terms: D017732:Air Ambulances / Q000458:organization & administration / Q000592:standards; D004651:Employment; D006801:Humans; D009520:New Zealand; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000600:supply & distribution; D000078329:Workforce