Click here to go NETS home page Emergency Obstetric and Neonatal Referrals Policy. 

Responsibilities of Tertiary Hospitals

The following policy was developed by the NSW Pregnancy and newborn Services Network (PSN) of the NSW Health Department.

The Obstetric Admitting Officer (obstetric patients) or the Neonatal Registrar (neonatal patients) at the Tertiary Centre of first call is expected to solve the referring hospital's problem, including:

  1. Ensuring that the appropriate and optimal management is occuring in the referring hospital.
  2. Offering clinical advice.
  3. Consulting with the duty obstetric or neonatal advisor for their hospital
  4. Accepting the transfer request if a bed is available.
  5. If no bed available, arranging an alternative destination. This may involve tertiary hospital staff liaising with colleagues in several hospitals before the patient's need is met. It is vital that any delays incurred in bed-finding do not delay the transfer or compromise the patient's condition. A call to review progress is advised.

Notes

  1. Bedstate information is displayed in each Tertiary Centre about all Tertiary Centres. This information is updated at least twice daily.
  2. NETS should be called (1300 36 2500) if exhaustive attempts to locate a bed are unsuccessful.
  3. Referring staff sometimes request medical retrieval of an obstetric patient believing that it will speed the process of transfer to make such a request. Medical retrieval is indicated if the patient needs criticalc are, anæsthetic or emergency medicine skills. Medical retrieval teams for many obstetric patients will not enhance the obstetric skills involved. A midwife excort from the referring hospital (road transfers) or an Air Ambuilance flight nurse/midwife (for air ambulance transfers) is suitable for the majority of emergency obstetric transfers.
  4. Advise the referring hospital staff that the ambulance service will better understand the needs if a clinical person rather than a clerk makes the ambulance booking. The level of urgency should be clearly speficied (eg. "urgent" or "within 1 hour" or "today").
  5. Each hospital should determine policies as to how the obstetric and neonatal staff jointly respond to emergency transfer requests, including communicating between each other. While neonatal bed availability may be an issue, acceptance of an obstetric patient does not necessarily impose a patient on the NICU or the need for a NICU bed many be days away.

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