EDITIONEN·FR·ქართ
ASF Logo

Accréditation Sans Frontières

International Accreditation of Healthcare Facilities

Start accreditation  

Accréditation Sans Frontières · ASF Health Standards 9.0

Standard 28 · Medical Transport

32 criteria · optional module (declare to apply)

Optional module (declare to apply). 32 criteria, of which 16 non-negotiable. Each criterion is numbered 28.Y, with its classification and verification questions.

Criteria

28.1 Vehicle Maintenance Current and Documented

NON-NEGOTIABLE

Every transport vehicle has a current, documented maintenance record meeting or exceeding manufacturer and national roadworthiness requirements, with no vehicle used for patient transport past its maintenance due date.

VERIFICATION QUESTIONS

  1. Does a maintenance log exist for every vehicle, with the most recent service within its required interval?
    Each vehicle has a record, and its last service is within the interval.
  2. Is any vehicle past its maintenance due date still in active patient transport use?
    A vehicle overdue for service should not carry patients.
  3. Are pre-shift vehicle checks performed and logged by the crew before each transport?
    Checks before each transport catch faults early.

28.2 Medical Equipment Checked and Calibrated

NON-NEGOTIABLE

Medical equipment carried on board — monitors, defibrillators, ventilators, oxygen delivery — is checked before each shift, calibrated per manufacturer schedule, and any malfunctioning equipment is immediately removed from service.

VERIFICATION QUESTIONS

  1. Is a documented pre-shift equipment check completed, not just available as a checklist nobody fills in?
    The check is completed, not only available.
  2. Is calibration current on every piece of equipment requiring it, verifiable by certificate or log?
    Calibration is evidenced, not assumed.
  3. Where equipment malfunctions mid-shift, is there a documented, followed procedure for removing it from service immediately?
    Equipment that fails in service is removed at once.

28.3 Medication Storage Meets Requirements

NON-NEGOTIABLE

Medications carried on board are stored at required temperature, secured against unauthorised access, checked for expiry on a fixed schedule, and controlled substances are logged with chain-of-custody discipline.

VERIFICATION QUESTIONS

  1. Is medication storage temperature monitored, not just assumed from the storage unit's general function?
    Storage temperature is monitored, not assumed.
  2. Are expired medications found during checks, and if so, is the expiry-check schedule reviewed?
    Expired stock on checks shows whether the schedule is working.
  3. Are controlled substances logged with a chain of custody, not a count that relies on trust alone?
    Controlled substances are accounted for at every transfer.

28.4 Vehicle Safety Equipment Present and Functional

CORE

Every vehicle carries functional safety equipment appropriate to its operating environment — fire extinguisher, first aid kit beyond patient care supplies, hazard triangles, communication backup — checked on the same schedule as medical equipment.

VERIFICATION QUESTIONS

  1. Is safety equipment checked on a fixed schedule, not only noticed missing when needed?
    Safety equipment is checked on a fixed schedule.
  2. Does communication backup exist for areas with known cellular or radio coverage gaps on regular routes?
    Crews on routes with poor coverage need a backup.
  3. Is safety equipment checked independently, rather than relying only on crew self-report?
    Independent checks, not only crew self-report.

28.5 Crew Scope of Practice Matches Transport Acuity

NON-NEGOTIABLE

Every transport is staffed with crew whose certified scope of practice matches or exceeds the clinical acuity of the patient being transported, verified before departure, not assumed from general crew availability.

VERIFICATION QUESTIONS

  1. Is patient acuity formally assessed before crew assignment, not left to informal judgement?
    Acuity is assessed before crew are assigned.
  2. Can the facility show a recorded example of a transport being delayed or reassigned because available crew did not match required acuity?
    A recorded case where a crew mismatch led to delay or reassignment.
  3. Can crew scope-of-practice certification be verified as current for any crew member on request?
    Certification can be verified on request.

28.6 Certification Current, Not Lapsed

NON-NEGOTIABLE

Every crew member's clinical certification — paramedic, EMT, nursing, or equivalent — is current and verified before each shift, with no crew member working a transport shift on a lapsed certification. Clinical performance and competency are also formally evaluated on a defined schedule, distinct from certification currency alone.

VERIFICATION QUESTIONS

  1. Is certification status checked before each shift, not only at hiring?
    Certification is checked before every shift, not only at hiring.
  2. Can the facility show that no crew member has worked a shift on a lapsed certification?
    Working on a lapsed certification is a serious breach.
  3. Is there a documented process for immediately standing down a crew member whose certification lapses?
    A defined response when certification lapses.
  4. Is each crew member's clinical performance and competency formally evaluated on a defined schedule, documented and shared with them?
    Performance and competency are evaluated and shared with the crew member.

28.7 Driver Training Specific to Patient Transport

CORE

Drivers complete training specific to emergency or patient transport driving — distinct from a standard driving licence — covering safe emergency driving, patient-comfort driving technique, and route-specific hazards.

VERIFICATION QUESTIONS

  1. Does driver training go beyond a standard licence, covering patient-transport-specific technique?
    Training goes beyond a standard licence.
  2. Is training refreshed on a schedule, not completed once at hiring?
    Refresher training at intervals, not once at hiring.
  3. Are drivers briefed on known hazards for regularly travelled routes?
    Drivers know the hazards on their regular routes.

28.8 Fatigue Management for Long-Distance Transport

CORE

A documented fatigue management policy governs maximum shift length and mandatory rest periods for crew on long-distance or inter-city transports, with actual shift records monitored against the policy.

VERIFICATION QUESTIONS

  1. Does a written fatigue policy exist with specific, defined limits, not a vague expectation of "reasonable" shifts?
    Clear limits, not a vague expectation of reasonable shifts.
  2. Are actual shift records checked against the policy, or does the policy exist without monitoring?
    Policy limits are monitored against actual shift records.
  3. Can the facility show a recorded example of a shift being adjusted specifically to prevent a fatigue policy breach?
    A recorded case where a shift was adjusted to stay within policy.

28.9 Minimum Crew Complement Per Transport Type

STANDARD

A written policy defines the minimum crew complement — number and qualification mix — required for each transport acuity level, applied consistently regardless of staffing availability pressure.

VERIFICATION QUESTIONS

  1. Does a written policy specify minimum crew numbers and qualification mix per acuity level?
    Minimum crew and qualifications are written down for each level.
  2. Has a transport ever proceeded below the minimum complement due to staffing pressure?
    A recorded case where staffing pressure lowered the crew below the minimum.
  3. Is the minimum complement policy applied consistently across all shifts, including nights and weekends?
    The policy applies on nights and weekends too.

28.10 Pre-Transport Clinical Assessment Completed

NON-NEGOTIABLE

Every patient receives a documented clinical assessment confirming fitness for transport before departure, performed by qualified crew, not inferred from the sending facility's referral paperwork alone.

VERIFICATION QUESTIONS

  1. Is a hands-on assessment performed by transport crew before departure, not just a review of sending paperwork?
    A hands-on check, not only a review of paperwork.
  2. Is the assessment documented, not just performed informally with no record?
    The assessment is recorded.
  3. Can the facility show a recorded example of a transport being delayed or declined based on this assessment?
    A recorded case where the assessment changed the decision.

28.11 Transport-Level Classification Matches Patient Need

NON-NEGOTIABLE

Each transport is classified by required care level — basic, advanced, critical care — based on the patient's actual clinical needs, with the assigned vehicle, crew, and equipment matching that classification before departure.

VERIFICATION QUESTIONS

  1. Is classification based on a documented clinical assessment, not a default or convenience-driven assignment?
    Classification comes from a clinical assessment, not habit.
  2. Where a mismatch between classification and available resources occurs, is there a documented escalation or resolution?
    A recorded route for resolving a mismatch.
  3. Is classification reassessed if the patient's condition changes before departure?
    Classification is updated if the patient changes before departure.

28.12 Continuous Monitoring Appropriate to Acuity

NON-NEGOTIABLE

Patient vital signs and clinical status are monitored continuously throughout transport at a frequency appropriate to acuity, with monitoring results documented at regular intervals, not only at departure and arrival.

VERIFICATION QUESTIONS

  1. Are vital signs recorded at intervals throughout transport, not just at the start and end?
    Vital signs are recorded during the journey.
  2. Does monitoring frequency scale with acuity, higher for critical transports?
    Monitoring is more frequent for more critical patients.
  3. Is monitoring equipment appropriate to the classification level on board and functioning?
    Equipment suited to the level of care, and working.

28.13 Deterioration Recognition and Response

CORE

Crew are trained to recognise clinical deterioration during transport using a defined, scored assessment tool, with a documented response procedure including diversion to the nearest appropriate facility when needed.

VERIFICATION QUESTIONS

  1. Is a defined, scored deterioration tool used, not just informal clinical impression?
    A scored tool, not clinical impression alone.
  2. Can the facility show a recorded example of a diversion decision made based on deterioration during transport?
    A recorded case where deterioration led to diversion.
  3. Do crew know, without hesitation, the criteria that trigger diversion versus continuing to the planned destination?
    Crew know the criteria without checking.

28.14 Patient Consent and Information Obtained

CORE

Patient or authorised representative consent for transport is obtained and documented before departure, with the patient informed in understandable terms of the transport plan and destination, and their right to decline transport honoured.

VERIFICATION QUESTIONS

  1. Is consent documented, not simply assumed from the patient's presence or sending facility referral?
    Consent is recorded, not assumed.
  2. For a patient unable to consent directly, is there a documented process for obtaining consent from an authorised representative?
    A defined route to consent for a patient who cannot give it.
  3. Is the patient told the destination and basic transport plan in understandable terms?
    The patient understands where they are going and why.
  4. Is the patient's right to decline transport explicitly stated and honoured, with crew able to describe what happens when exercised?
    The right to decline is stated, and crew know what follows.

28.15 Structured Handover at Pickup

NON-NEGOTIABLE

A structured, standardised handover is conducted between sending facility staff and transport crew at pickup, covering clinical status, treatment given, allergies, and specific concerns, not an informal verbal summary.

VERIFICATION QUESTIONS

  1. Is a standardised handover format used, not a verbal summary that varies by who is handing over?
    A standard format, not a summary that varies with the person.
  2. Does the handover cover allergies and specific concerns explicitly, not just general diagnosis?
    Allergies and concerns are stated, not left to a general diagnosis.
  3. Is the handover documented, with both parties' acknowledgment?
    Both sides confirm the handover.

28.16 Structured Handover at Destination

NON-NEGOTIABLE

A structured handover is conducted between transport crew and receiving facility staff at arrival, covering changes in status during transport, interventions performed en route, and current clinical status, with receiving staff acknowledgment.

VERIFICATION QUESTIONS

  1. Does the destination handover specifically cover what changed during transport, not just a repeat of the pickup information?
    Changes during transport are handed over.
  2. Is there documented acknowledgment from receiving staff that handover was received?
    The receiving staff confirm they received it.
  3. Is the handover given directly to a responsible clinician, not left with whoever happens to be nearby?
    The handover goes to a responsible clinician.

28.17 Real-Time Status Communication to Dispatch

CORE

Crew communicate transport status to dispatch at defined checkpoints throughout the journey, with a documented escalation procedure if expected communication is missed.

VERIFICATION QUESTIONS

  1. Are checkpoint communications happening at defined intervals, not only at departure and arrival?
    Communication at intervals during the journey.
  2. Is there a documented procedure for what dispatch does when an expected checkpoint communication does not arrive?
    A defined response when a checkpoint is missed.
  3. Can the facility show a recorded example of this escalation procedure being used?
    A recorded case where the escalation was used.

28.18 Written Documentation Accompanies Patient

CORE

Complete written documentation — transport record, medications given, vital sign trends, any incidents — physically or digitally accompanies the patient to the receiving facility, not relying on verbal handover alone.

VERIFICATION QUESTIONS

  1. Does written documentation arrive with the patient, not sent separately or left incomplete?
    Documentation travels with the patient.
  2. Does the documentation include vital sign trends throughout transport, not just final values?
    Trends during transport, not only the final values.
  3. Are any incidents or interventions during transport clearly documented, not omitted if they resolved without lasting effect?
    Incidents are recorded even if they resolved.

28.19 Language-Appropriate Communication With Patient

STANDARD

Where crew and patient do not share a language, a practical communication method — phone interpretation, translation cards, or equivalent — is available and used during transport, not simply skipped due to practical difficulty.

VERIFICATION QUESTIONS

  1. Is a practical interpretation method available on board, not just theoretically accessible?
    A method the crew can use on board.
  2. Can the facility show a recorded example of this method being used during an actual transport?
    A recorded case of the method being used.
  3. Can crew describe how to access the interpretation method without hesitation?
    Crew can use the method without delay.

28.20 Vehicle Cleaned and Disinfected Between Patients

NON-NEGOTIABLE

The patient compartment and all contact surfaces are cleaned and disinfected according to a written protocol between every patient transport, with the cleaning completed and verifiable, not assumed from a general end-of-shift routine.

VERIFICATION QUESTIONS

  1. Is cleaning completed between every patient, verifiable through a log or checklist, not assumed?
    Cleaning between patients is recorded.
  2. Does the protocol specify contact time for disinfectant, not just a wipe-down?
    Disinfectant needs time to work, not a quick wipe.
  3. Is there a documented process for enhanced cleaning after a known infectious transport?
    A defined process after an infectious transport.

28.21 Personal Protective Equipment Available and Used

NON-NEGOTIABLE

Appropriate PPE is stocked on every vehicle in adequate supply, matched to the transport's known or suspected infectious risk, and observed to be worn by crew during patient contact.

VERIFICATION QUESTIONS

  1. Is PPE worn correctly during patient contact, as observed in practice?
    Observed use, not only availability.
  2. Is PPE stock checked and restocked on a fixed schedule, not discovered depleted mid-shift?
    PPE stock is checked on a schedule.
  3. Is higher-level PPE available and used for known or suspected higher-risk transports?
    Higher-level PPE for higher-risk transports.

28.22 Isolation and Transmission-Risk Transport Protocol

NON-NEGOTIABLE

A written protocol governs transport of patients with known or suspected transmissible infection, including crew PPE escalation, vehicle configuration, and advance notification to the receiving facility.

VERIFICATION QUESTIONS

  1. Does the protocol specifically address advance notification to the receiving facility, not just on-board precautions?
    The receiving facility is warned in advance.
  2. Can crew describe the protocol's key steps without needing to look it up?
    Crew know the key steps from memory.
  3. Can the facility show a recorded example of this protocol being followed for an actual transmissible-infection transport?
    A recorded case of the protocol being followed.

28.23 Sharps and Biohazard Waste Disposal

CORE

Sharps and biohazardous waste generated during transport are contained in appropriate on-board containers and disposed of through a licensed regulated pathway at the earliest point of return, never accumulated loosely or disposed of informally.

VERIFICATION QUESTIONS

  1. Are sharps containers present and accessible on board, not left behind to save space?
    Sharps containers are on board and within reach.
  2. Is disposal documented through a licensed pathway, not an informal arrangement?
    Disposal is through a licensed route, documented.
  3. Are sharps containers replaced before reaching unsafe fill levels?
    Containers are replaced before they are full.

28.24 Crew Exposure Incident Response

CORE

A written protocol governs crew response to a biological exposure incident during transport, including immediate first aid, reporting, and post-exposure medical follow-up, with the protocol accessible and known regardless of location during transport.

VERIFICATION QUESTIONS

  1. Can crew describe the protocol's first steps without consulting a document, including while away from base?
    Crew know the first steps even away from base.
  2. Is post-exposure medical follow-up accessible from any point on a typical route, not only near base?
    Follow-up is reachable along the usual route.
  3. Can the facility show a recent recorded exposure incident, and did the response match the written protocol?
    A recorded case, checked against the protocol.

28.25 Cardiac Arrest / Life-Threatening Event Protocol

NON-NEGOTIABLE

A written protocol governs crew response to cardiac arrest or other immediately life-threatening deterioration during transport, including whether to stop, continue, or divert, with crew trained and drilled on this decision-making, not improvising in the moment.

VERIFICATION QUESTIONS

  1. Can crew describe the stop-versus-continue decision criteria without hesitation?
    Crew know when to stop and when to continue.
  2. Has this protocol been drilled, not only distributed as a document?
    The protocol has been practised, not only issued.
  3. Can the facility show a recorded example of this protocol being followed during an actual event?
    A recorded case of the protocol being followed.

28.26 Nearest Appropriate Facility Diversion Capability

NON-NEGOTIABLE

Crew have real-time access to information on the nearest appropriate facility along any route, with a defined, practised process for diverting there when a patient's condition requires it, rather than continuing to the originally planned destination regardless.

VERIFICATION QUESTIONS

  1. Do crew have actual, current access to nearby facility information en route, not relying on memory or an outdated reference?
    Current information on nearby facilities, available en route.
  2. Can the facility show a recorded example of diversion occurring when needed?
    A recorded case of diversion when it was needed.
  3. Is the decision to divert made by crew directly, without needing to wait for distant approval that could cause dangerous delay?
    Crew can divert without waiting for approval that could cause delay.

28.27 Vehicle Breakdown or Accident Contingency

CORE

A written contingency plan covers vehicle breakdown or accident during a patient transport, including backup vehicle dispatch, patient safety measures, and notification protocols, tested at a defined interval.

VERIFICATION QUESTIONS

  1. Does the plan specifically address patient safety during the breakdown period, not just vehicle recovery logistics?
    Patient safety is planned for during a breakdown.
  2. Has backup vehicle dispatch been tested, with a known realistic response time?
    Backup dispatch is tested, with a realistic response time.
  3. Do crew know their specific role during a breakdown, not just that a plan exists?
    Crew know their role, not only that a plan exists.

28.28 Mass Casualty / Multi-Patient Surge Plan

CORE

Where the organisation's scope includes response to mass casualty or multi-patient events, a written surge plan covers resource allocation, triage coordination with other responders, and communication with receiving facilities.

VERIFICATION QUESTIONS

  1. Is the plan specific to the organisation's actual scope and typical operating area, not a generic template?
    A plan written for the organisation's own area.
  2. Does the plan specifically address coordination with other responders, not just internal resource allocation?
    Coordination with other responders is planned.
  3. Has the plan been exercised, even at a tabletop level, within a defined interval?
    The plan is exercised, even on paper, at intervals.

28.29 Post-Incident Debrief and Review

STANDARD

Following any significant clinical event, breakdown, or diversion during transport, a structured debrief is conducted with involved crew, with findings feeding into the organisation's corrective action process.

VERIFICATION QUESTIONS

  1. Is a debrief conducted after significant events, not skipped if the outcome was ultimately fine?
    A debrief after significant events, even when the outcome was good.
  2. Do debrief findings feed into corrective action, or do they stay as an informal conversation with no follow-through?
    Debrief findings lead to corrective action.
  3. Is the debrief blameless, encouraging honest input rather than defensive accounts?
    Honest accounts are encouraged.

28.30 Critically Ill Patients Are Transported With Appropriate Staff and Equipment

NON-NEGOTIABLE

A patient whose condition is critical is transported with a crew, equipment and monitoring matched to that condition, and the transfer is planned before it begins.

VERIFICATION QUESTIONS

  1. Is the crew for a critically ill transfer matched to the patient's condition, with the required level of training present?
    A critically ill patient needs care that a standard crew cannot give.
  2. Is the equipment and monitoring for the transfer checked before departure, and is the check recorded?
    Equipment that fails in transit may not be replaceable there.
  3. Is the transfer planned with the receiving facility, including the route and the clinical handover?
    A transfer without a planned receiving team exposes the patient to delay.

28.31 Neonatal and Paediatric Transfers Use Specialist Arrangements

CORE

Transfers of newborn and paediatric patients are made with crew, equipment and temperature and monitoring arrangements designed for those patients, and with a clinician agreed in advance.

VERIFICATION QUESTIONS

  1. Is the crew trained for neonatal or paediatric transfer, with the training recorded?
    Equipment and dosing for a newborn differ from those for an adult.
  2. Are temperature control and monitoring for the patient maintained throughout the transfer?
    Hypothermia in a newborn can be a serious and avoidable harm.
  3. Is a clinician agreed in advance for the transfer where the patient's condition requires one?
    A transfer without a clinician for a complex patient is unsafe.

28.32 Air Transport Is Planned and Controlled Where Declared

STANDARD

Where a facility declares air transport, the transfer is planned, the aircraft and crew are authorised for the purpose, and the decision to use air transport is recorded with its reasons.

VERIFICATION QUESTIONS

  1. Are air transfers authorised under the rules that govern them, and is the authorisation recorded?
    Air transport without authorisation is not a safe transfer.
  2. Is the decision to use air transport recorded with the reasons and alternatives considered?
    A decision that cannot be reviewed cannot be learned from.
  3. Is the patient's condition checked as fit to fly before departure, and is the check recorded?
    Some conditions can change at altitude. ————————————————————

← All ASF Health Standards

© 2026 Accréditation Sans Frontières · PHIG · Sheni Network