b'is a safe transport modality for thisREGULATORY AND OPERATIONALHospital and health system policies patient and they are transported withCONSIDERATIONS on this matter should recognize NAVIT their IV in place.as an appropriate transport modality Using NAVIT for interfacility transportand provide safeguards for physicians In each case, ambulance transport delaysbenefits patients and communities: utilizing this transport modality care without improving safety and orReduced ED crowding: Stable patientsappropriately. outcomes. And also adds cost. In all cases, the sending emergency physicianare not left boarding in the ED awaitingThe American College of Emergency had a discussion with the patient andambulance availability, freeing up spacePhysicians (ACEP) has recognized the considered the risks and benefits ofand staff for acute cases. need for further clarity on this matter NAVIT, and ultimately in joint decision Preserved EMS resources: Interfacilityand has convened a subcommittee thatmaking it was recognized as a safetransfers often remove ambulancesis tasked with addressing this topic. treatment modality.from service for extended periods. NAVIT helps keep EMS units availableCONCLUSIONEMERGING SUPPORTINGfor true emergencies, reducing burnout EVIDENCE and reinforcing their core mission. NAVIT should be recognized as a valid and safe interfacility transport modality This practice is supported by data butLower patient costs: Many insurers dowhen the sending physician determines not without limitations. A retrospectivenot fully cover interfacility ambulanceit is appropriate. For the right patient, study conducted at WellSpan Health,transport. For patients with deductiblesNAVIT does more than maintain timely presented at the 2024 ACEP Scientificor cost-sharing, NAVIT can beaccess to careit reduces cost, preserves Assembly and published in the Americansignificantly less expensive. EMS resources, and reduces unnecessary Journal of Emergency Medicine, evaluatedNAVIT is consistent with EMTALA andED boarding, crowding and wait times. interfacility transfers by private vehiclefederal transfer requirements when: As emergency physicians and system between December 2020 and April 2024. leaders, we must match transportThe patient is stable for transfer.Findings included: resources to clinical need. When usedThe receiving facility has accepted thejudiciously, NAVIT represents smart,All patients were deemed stable by the patient. patient-centered care in an increasingly sending emergency physician. strained health system. The sending physician determinesNone required ambulance-level NAVIT is medically appropriate. Emergency physicians should work with monitoring or intervention. their hospitals and health systems to No adverse events occurred duringDocumentation and communicationcreate policies and procedures to safely transport or upon arrival at theprotocols are followed. transport patients via NAVIT when the receiving facility. It is important to emphasize that EMTLAsending physician deems it appropriate. These results reinforce that whendoes not require IFT via ambulance. patients are carefully selected, NAVIT wasIt is also important to note that initial evaluation and stabilization are requiredDay E, Breighner R, Flamm A. Non-ambulance vehicle a safe and effective option. However, theper EMTALA, and these obligations areinterfacility transport (NAVIT) was not associated study had many limitations which arenot negated by transport to anotherwith adverse patient outcomes. Am J Emerg Med. listed in the manuscript.Published online August 20, 2025. doi:10.1016/j.facility no matter the transport modality.ajem.2025.08.021PACEP News | Fall 2025 23'