Ensuring a smooth journey: new role helps sick babies and kids get the care they need
The most seriously ill infants, children and teens can only get intensive care from a handful of specialized children’s hospitals across Ontario. In our region, that children’s hospital is Hamilton Health Sciences McMaster Children’s Hospital (MCH), home to a “level 3” neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) which provide a specialized level of care for children.
When three-month-old Matteo Mancuso (centre) had to travel between hospitals for specialized care, the MCH transport team was there for him and his family every step of the way.
When a child at a local community hospital needs specialized intensive care, they need to be moved to MCH. Kids can travel with a dedicated transport health care team in an ambulance, or by air in a helicopter or airplane, depending on the distance to MCH. The team that transports these patients are highly skilled transport nurses and breathing specialists, called respiratory therapists, who are experienced in managing care for critically ill and injured children.
“We see families at a vulnerable time in their lives, with a sick infant or child who needs to be moved to another level of care. It is our privilege to be able to make such a stressful and scary time a little bit easier and smoother.”
As part of the Growing MCH project, the hospital received new provincial funding to enhance our NICU and PICU transport teams through the addition of transport coordinators. These coordinators play a crucial role in managing and streamlining the complex processes involved in organizing patient transfers across the province.
Their efforts ensure that children in need of urgent specialist care at MCH receive timely triage, dispatch, and stabilization support, enabling faster and more efficient critical care services within our community.
Transport coordinators provide coordination and advice
Inside the medical transport airplane (Submitted by the Mancuso family)
MCH’s four transport coordinators support both the NICU and PICU transport teams. By handling critical logistical tasks, transport coordinators enable the dispatched transport team to concentrate fully on delivering exceptional medical care to patients.
Transport coordinators bring a high level of expertise and problem-solving skills, allowing them to respond swiftly and strategically to calls. They support the team by managing multiple requests and coordinating efforts to ensure patients are transported quickly and safely, enabling urgent care to begin as soon as possible. Collaborating closely with clinical teams, they provide guidance, triage patients, and assist with dispatching staff, all with the goal of achieving the best possible outcomes for patients.
When a patient at a community hospital is identified as needing a higher level of care, the referring hospital contacts CritiCall Ontario, an organization dedicated to facilitating access to urgent and emergent care across the province.
If MCH is deemed the most suitable facility by CritiCall, a team of transport clinicians, a transport coordinator, and a physician meet to take the call. Together, they gather critical information from the referring hospital and create the best care plan for the patient.
For example, if a call is received for an infant requiring specialized care at MCH, the team provides immediate guidance to the community hospital on how to provide the best care for the infant until the transport team arrives. During this time, the transport coordinator stays on the line to follow up with health care providers, offering additional advice and tracking patient updates to ensure seamless coordination before the team’s arrival.
Many critical care transports also involve supporting ongoing breathing support or CPR for children in community hospitals. These transports are particularly challenging and need a very synchronized coordination of local, regional and provincial services to provide the best care possible.
At other times, our team can give advice over the phone and the patient is able to remain at the local site. The coordinator will work with the medical teams to ensure follow-up continues as needed.
Strong partnerships ensure a smooth journey
Matteo received care from the transport team (Submitted by the Mancuso family)
Some patient transports involve returning a child to their home hospital after receiving specialized care at MCH. For example, if a child is brought to MCH for breathing support and has stabilized to the point where their local hospital can manage their care, the transport team facilitates their safe return.
In other cases, a patient may need to be transferred to another hospital for a specific test or procedure. While most of these transfers occur within the region, some require out-of-province travel to access highly specialized pediatric services.
The transport service requires partnerships between MCH, Hamilton Paramedic Service, CritiCall, ORNGE, community hospitals, the three other children’s specialty hospitals in the province and their transport teams, and even local airports.
Transport coordinators make stressful flight to Edmonton smooth for family
Stacy McKerracher
For the Mancuso family, the transport team helped to bring their three-month-old Matteo from MCH, where he was being cared for in the NICU since birth, to an Edmonton hospital by air.
“This isn’t a typical transfer. These out-of-province transfers are incredibly rare – yearly at most,” says Stacy McKerracher, NICU clinical leader who supports the neonatal transport team, “but they do exemplify the incredible coordination and attention our coordinators put into planning these critical transfers.”
Matteo needed a specialized PET scan, an imaging test to see the body’s organs and tissues in 3D. This particular test is only offered for infants in Edmonton. The scan helped to determine what type of congenital hyperinsulinism he had so the team could develop the best care plan.
The family spent five days in Edmonton and needed to pack extra medication, equipment and supplies such as items required for Matteo’s feeding machine, in case any travel was delayed.
“The team was amazing,” says Matteo’s mom Melissa. “They went over every detail.”
Although the experience was stressful, it went smoothly and the family knew they were in good hands.
“The coordination from McMaster Children’s Hospital to Stollery Children’s Hospital in Edmonton and the return to McMaster was a complicated process,” says McKerracher. “The transport coordinators were able to focus on the longer term plans, allowing the transport clinicians to go about their day-to-day business transporting infants and children based on their required needs.”
MCH has a regional responsibility
Karen Schattauer, RN
All of MCH’s transport coordinators are experienced transport clinicians. They started in the new coordinator role in June 2024.
Karen Schattauer was one of the coordinators involved in Matteo’s out-of-province transport.
“This new role at MCH was key in the smooth implementation of this transfer, including coordinating equipment lists, physician orders for the patient while on transport, and transfer of accountability to the Edmonton team on arrival. This new role will allow faster response times of our transport teams, as well as facilitate getting the right patient to the most appropriate level of care in a more timely fashion,” she says.
“We see families at a vulnerable time in their lives, with a sick infant or child who needs to be moved to another level of care. It is our privilege to be able to make such a stressful and scary time a little bit easier and smoother.”
The MCH regional coverage for specialized programs like the NICU and transport spans a vast area including Fort Erie, Niagara Falls, Simcoe, Mount Forest, Milton, and Oakville. This region serves a population of approximately three million people.
“MCH transport teams have a regional responsibility to transport patients that cannot be managed or stabilized at their home hospital, and then bring them back to the appropriate level of care,” says McKerracher. “Our NICU and PICU teams work together to ensure that children who require our level of care are able to receive it. We also work closely with our provincial transport partners to ensure all kids and teens in the province receive timely access to care.”
