Hand Off the Patient and Open an ED Visit

The handoff is the moment the ambulance’s work ends and the hospital’s begins. It is the arrival summary the paramedic hands to the receiving team when the patient reaches the destination. For a known patient brought to the Emergency Department, this single action does a lot at once: it opens the receiving ED visit (the system’s record of an emergency attendance) so the ED nurse sees the patient on the board, closes the run, frees the ambulance, closes the call, and bills the run. Recording the handoff is the paramedic’s last step on the run sheet.

Who / when: Funke the paramedic records the handoff when she reaches the receiving unit, on the signed run sheet. Nurse Grace, the receiving ED nurse, then picks the patient up from the ED board — she sees the inbound arrival and the pre-hospital summary, but she does not touch the ambulance record itself (the ED team’s access to it is read-only).

We will follow the chest-pain run from the previous guide arriving at the hospital.

1. Paramedic — on the signed run in Ambulance & EMS → Run Sheets, press “Record Handoff”. (The button only appears once the sheet is signed and no handoff has been recorded yet.)
2. Paramedic — fill in the handoff: the receiving unit (e.g. “Emergency Department”), received by (the name of whoever took over), and the handover summary — the concise account of the patient’s condition and what was done en route. Tick “Pre-alert was phoned ahead” if you radioed ahead so the ED was waiting.
3. Paramedic — confirm. Veona records the handoff, marks the run HandedOff, frees the ambulance back to Available, and closes the emergency call.
4. System (for a known patient to the ED) — Veona opens a receiving ED visit through the hospital’s one canonical ED-arrival path. The visit is created with arrival = Ambulance, its acuity carried over from the call’s dispatch priority (P1 → Resus, P2 → ESI 2, and so on down to P4), and your handover summary attached as the reason and complaint. A top-acuity arrival lands straight in Resus.
5. ED nurse — Nurse Grace sees the patient appear on the ED board as an ambulance arrival, with the pre-hospital summary already attached, and picks them up. The ED then formally re-triages — the priority you sent is the arriving acuity, not the final word.
6. Anyone with read access — open Ambulance & EMS → Handoffs. The handoff row shows the linked ED Visit number, confirming the chain joined up end to end.

Note

The pre-hospital → ED chain is wired through the one ED creation path, the same one a walk-in triage uses — never a parallel back door. Because a run can have only one handoff, the ED visit is created exactly once and can never double-fire.

Caution

The ED visit only opens for a known patient handed to the in-house ED. If the call was an unidentified casualty (no patient linked), or you name an external facility as the receiving unit (a transfer to another hospital), the handoff is recorded as a summary only and no ED visit is created — the ED Visit column on Handoffs shows a dash. Likewise, a run with no linked patient is not billed: there is no patient to charge, and no later sweep picks it up once the casualty is identified.

What happens next

For a known-patient run, the close-out also bills automatically: the per-run fee (Ambulance Run) and, where a transport distance was recorded, a per-kilometre mileage line, plus any priced field consumables — all captured as charges against the patient through the same billable seam every clinical module uses. Once those charges are assembled into an issued invoice, Veona Bill posts the accrual to the General Ledger. From here the patient’s story continues inside the ED, and the run’s response times, fleet utilisation and revenue flow into Veona Pulse.

Follow the trail

• Previous: Take a Call, Dispatch, and Complete the Run Sheet
• Related: Triage an Emergency Patient to the Board · Admit an Emergency Patient to a Ward · One Set of Books · How a Charge Becomes an Invoice