A PIT for the Europe Hospitals as of 1 July

Etterbeek, 02/07/2024 - Since Monday 1 July, the Europe Hospitals have had a PIT (Paramedical Intervention Team) operating on the St-Michel site. It is one of three new PITs awarded by the Federal Government in the Brussels Region(1). As demonstrated in other countries, increasing the number of PITs is an excellent way of providing the best possible care to patients as quickly as possible. Very good news indeed for the people of Brussels!

Within the emergency medical service (AMU), there are three types of vehicle: the simple ambulance with two ambulance drivers wearing AMU badges, the SMUR with a medical and nursing pair, and the PIT with two ambulance drivers wearing AMU badges and a nurse specialising in emergency medical assistance and intensive care. "The PIT nurse will go out in the ambulance to provide first aid to the patient (under standing orders), while being able to call on the clinic's PIT referral doctor 24 hours a day if necessary, who will work in collaboration with him. So it's an intermediary vehicle between the simple ambulance and the SMUR," explains Dr Paule Denoël, head of the Europe Hospitals Emergency Department.

Six months of preparation

On 4 November 2023, the Europe Hospitals submitted its application for a PIT function. In January 2024, they received official notification that they had obtained a PIT function and an approval number for it. From that moment on, the machines were set in motion to activate this great project.

"We gave ourselves six months to implement the PIT project, working on different areas: training (training staff in this new form of care), administration (refining the federal standing order protocols, depending on the institution), legislation (based on expert advice, formalise the framework for out-of-hospital practice, with its obligations and limits) and the material aspect (the fully-equipped ambulance was supplied by the SIAMU, and the inventory of all the equipment needed for the interventions was compiled by the team of PIT referral nurses)", reports Christophe Delbushaye, head nurse in the Europe Hospitals Emergency Department. 

The implementation of the PIT on the St-Michel site is also a plus for the H.UNI hospital network to which the Europe Hospitals belong.  "The other hospitals in the network and our other site already had an SMUR. The development of a PIT on the St-Michel site, which did not have an out-of-hospital function, therefore seemed appropriate," explains Dr Denoël.

Benefits for patients and staff

"Initially, the St-Michel site had a 112 ambulance departure. Following the large number of missions carried out by the 112 ambulance from the St-Michel site, the SIAMU felt it was appropriate to set up a second ambulance departure in order to provide the most appropriate response to the population. We are now adding a PIT function to our range of services, which will further improve the speed with which more advanced care can be provided. Thanks to this PIT function, we're reducing the time taken to get treatment, especially for diseases where a delay in treatment could be harmful.  This is a definite benefit for patients," insists the emergency doctor.

As part of the implementation of the PIT, every effort has also been made to ensure that patients benefit from developments in medicine, and telemedicine in particular. "It's quite extraordinary.  I'm looking at a patient with chest pain. I'm going to do an ECG, which I'll be able to export as a pdf file in real time to the e-mail address of the emergency doctor, who will be able to view and analyse it while I'm on the line with him," comments Christophe Delbushaye.

Dr Denoël added: "What's more, this PIT is also an opportunity for the staff of the Europe Hospitals Emergency Department to further strengthen the collaboration between doctors and nurses, which will inevitably improve the quality of care - and to enable nurses with the SIAMU (Soins Intensifs et Aide Médicale Urgente) qualification who so wish to take up a new post, with the confidence of the institution. It's a great recognition of their profession".

To provide a 24-hour PIT service, 6 FTE nurses with EMS qualifications are needed. "We have a group of pioneering nurses in-house who are motivated by the role, and the door is open to new commitments. The EMS nurses know that they will be able to excel in the PIT function, which is why we have already received a number of applications," says the head nurse. "And in any case, we have the staff to currently operate 12 hours a day (as planned in phase 1) and everything will be in place to be able to provide the function 24 hours a day from 1 January 2025. It's clear that the training and supervision programme put in place for the first candidates is attracting others."

Ongoing monitoring

All PIT interventions will be debriefed within the department itself, and quality indicators will be defined so that we can assess how staff training can be improved, particularly according to the type of intervention for which PIT is most frequently called upon.

"This ongoing monitoring is important not only to constantly improve the quality of care provided to patients, but also to ensure that staff are recognised for their experience in the field and to fine-tune their training as much as possible," concludes Christophe Delbushaye.

(1) Until now, the Brussels Region had 3 PITs. From now on, there will be 6.