title: QUIT EMR trial: a prospective, observational, multicentre study to evaluate quality and 24 hours post-transport morbidity of interhospital transportation of critically ill patients: study protocol.
abstract: It is widely accepted that transportation of critically ill patients is high risk. Unfortunately, however, there are currently no evidence-based criteria with which to determine the quality of various interhospital transport systems and their impact on the outcomes for patients. We aim to rectify this by assessing 2 scores which were developed in our hospital in a prospective, observational study. Primarily, we will be examining the Quality of interhospital critical care transportation in the Euregion Meuse-Rhine (QUIT EMR) score, which focuses on the quality of the transport system, and secondarily the SEMROS (Simplified EMR outcome score) which detects changes in the patient's clinical condition in the 24 hours following their transportation.
  
  
  
  A web-based application will be used to document around 150 pretransport, intratransport and post-transport items of each patient case.To be included, patients must be at least 18-years of age and should have been supervised by a physician during an interhospital transport which was started in the study region.The quality of the QUIT EMR score will be assessed by comparing 3 predefined levels of transport facilities: the high, medium and low standards. Subsequently, SEMROS will be used to determine the effect of transport quality on the morbidity 24 hours after transportation.It is estimated that there will be roughly 3000 appropriate cases suitable for inclusion in this study per year. Cases shall be collected from 1 April 2015 until 31 December 2017.
  
  
  
  This trial was approved by the Ethics committees of the university hospitals of Maastricht (Netherlands) and Aachen (Germany). The study results will be published in a peer reviewed journal. Results of this study will determine if a prospective randomised trial involving patients of various categories being randomly assigned to different levels of transportation system shall be conducted.
  
  
  
  NTR4937.
authors.affiliation: Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Strauch
authors.affiliation: Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Dennis C J J
authors.initials: DC
authors.lastname: Bergmans
authors.affiliation: Emergency Medical Service district of Aachen, Aachen, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Habers
authors.affiliation: Emergency Medical Service South Limburg, Geleen, The Netherlands.
authors.forename: Jochen
authors.initials: J
authors.lastname: Jansen
authors.affiliation: Department of Methodology and Statistics, Maastricht University, CAPHRI School for Public Health and Primary Care, Maastricht, The Netherlands.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Winkens
authors.affiliation: Maastricht University, MEMIC Center for Data and Information Management, Maastricht, The Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Veldman
authors.affiliation: Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
authors.forename: Paul M H J
authors.initials: PM
authors.lastname: Roekaerts
authors.affiliation: Emergency Medical Service, Fire Department, Aachen, Germany.
authors.forename: Stefan K
authors.initials: SK
authors.lastname: Beckers
mesh_terms: D000328:Adult; D000552:Ambulances; D003422:Critical Care; D016638:Critical Illness; D005858:Germany; D006304:Health Status; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D009017:Morbidity; D009426:Netherlands; D010360:Patient Transfer / Q000592:standards*; D011446:Prospective Studies; D011787:Quality of Health Care; D012107:Research Design; D018570:Risk Assessment; D014186:Transportation; D014187:Transportation of Patients / Q000592:standards*