HAAD Standard for Minimum Preparedness for Common Medical Emergencies

Document Title: In Inpatient Care Setting, Outpatient Care Setting, Ambulance Services and
Interfacility Patient Transfer
Document Ref. Number: HAAD/EMS/SD/0.9 Version 0.9
Approval Date: 23/12/2015 Effective Date: 23/12/2015
Document Owner: Health Regulation Department
Applies to: All HAAD Licensed Healthcare facilities
Classification:  Public

1. Purpose
1.1 The purpose of this Standard is to set out:
1.1.1 The requirements for HAAD Licensed Healthcare Facilities as defined by
HAAD (http://www.haad.ae/haad/tabid/127/default.aspx) to manage
emergency patients in response to patient needs until the patient recovers,
the patient is stabalised, transferred/referred to the appropriate healthcare
facility or until a specialised team assumes responsibility;
1.1.2 The required minimum medications and equipment to manage an
emergency response for inpatient settings, outpatient settings and
ambulance service providers;
1.1.3 The requirements for healthcare professionals employed at a
HAAD licensed healthcare facility.
1.1.4 The emergency vehicle requirements for the ambulance transfer of stable
and unstable patients
1.1.5 Establish the minimum requirements to provide safe, efficient and timely
support and transportation for elective and emergency patients to a HAAD
licensed healthcare facility, licensed by a UAE competent authority,
healthcare facility in other international jurisdictions licensed by the
country specific competent authority.

2. Scope
2.1. This standard applies to all HAAD licensed inpatient and outpatient healthcare
facilities and ambulance service providers as per HAAD Facility Licensing
definitions.

Page 1 of 13
 2.2. All HAAD licensed healthcare facilities and professionals involved with the
purpose of providing emergency services and ambulance services including
events transfer, interfacility patient transfer, emergency transfer from site of
accident or emergency transfer from the patients home.
2.2.1 Transfer of patients must be in accordance with HAAD licensure, scope of
service, the privileges granted by the healthcare facility and in compliance with
the UAE legal requirements.
2.3. This Standard only applies to ambulance vehicles used for emergency patient transfer, as set
out in section 2.2.
2.3.1 Ambulance Service Providers shall be given an eighteen (18) month grace
period to meet the vehicle requirements set out in this Standard during which
evidence and/or action plans to meet the requirements set out in this Standard
shall be submitted to HAAD upon licensure.
2.4 This Standard does not include the requirements for emergency transfer of
patients exposed to Chemical Biological Radiological and Nuclear Explosives
(CBRNE).

3. Definitions and abbreviations:

3.1 Emergency Medical Dispatch (EMD) System: Is the principle link between the
Public caller requesting emergency medical assistance and the emergency medical
service (EMS) resource delivery system.
3.2 Ambulance: An emergency vehicle, whether privately or publicly owned which is
designed, constructed and equipped to the level of service provisions or duly
modified for the sole transport of sick, disabled or injured individuals.
3.3 Ambulance service: the business of transporting sick, disabled or injured
individuals by ambulance to or from facilities or institutions providing health
services.
3.4 Ambulance Service Provider: a healthcare provider engaged in the business of
transporting injured, sick or disabled individuals by ambulance to or from
healthcare facilities providing health services or from non-health institutions to a
healthcare facility.
3.5 CEN 1789: is the European Union Standard for ambulance vehicles and medical
transportation vehicles.
3.6 Emergency response: Response is an effort to mitigate the impact of an incident
on the public and the environment that would otherwise threaten public safety,
health and welfare of an individual or a group of people.
3.7 Medical Oversight: Includes active day-to-day role in the function and
management of the service as it relates to patient care needs. Medical oversight
may be prospective (planning), indirect and offline (i.e. not directly engaged
during the emergency process) such as developing policies and procedures and
protocols for emergency and ambulance response, transfer and transport;
concurrent, direct and online such as giving verbal orders in person or via radio
(i.e. directly involved in the transfer and transport on site); retrospective, indirect
and offline such as quality management (i.e. after the event of transfer conducting
evaluation of the transfer system) and clinical audit.
3.7.1Medical oversight shall include having in place a protocol for issuance of
drugs (including narcotic and controlled substances) and training of their use
by authorised staff only;

Page 2 of 13
 3.7.1.1 This must be undertaken by a qualified physician with internationally
recognised qualifications and experience in Emergency Services;
3.7.2 Assigning responsible manager (authorised for decision making) to oversee, monitor
and report service performance
3.7.3 Ensuring appropriate and effective mechanisms to facilitate
consultation with treating physicians and specialty care physicians
(specialists/consultants)
3.7.4 Ensuring availability of appropriate mix of multidisciplinary team, its members
possessing the requisite levels of knowledge and skills in accordance with the service
needs
3.7.5 Tracking, monitoring, case review and quality management of a quality management
system
3.8 Interfacility Transfer: Any pre-arranged emergency or non-emergency transfer
including use of a retrieval service for patients, after initial assessment and
stabilisation, from one healthcare facility to another for reasons including but not
limited to the following:
3.8.1 The need for specialised treatment and care not available at the referring
facility; for example (professionals, equipment and requisite treatment);
3.8.2 Lack of bed capacity for the patient at the referring facility;
3.8.3 Patient eligibility of care and treatment in the referring facility in
accordance with their health insurance product except for emergency
cases. Patients must not be denied emergency care and management on
the basis of their health insurance product; as this breaches
Federal and Abu Dhabi Laws (Appendix 1)
3.9 Referring facility: A HAAD licensed healthcare facility referring and/or requesting
the transfer of patient care to another HAAD licensed facility.
3.10 Receiving facility: A HAAD licensed healthcare facility accepting the request for
transfer and admitting the patient referred by and/or transferred from another
HAAD licensed facility.
3.11 Transfer Coordinator Referring (TCRF): A designated individual from a HAAD
licensed healthcare facility who has been given the responsibility to coordinate
the transfer of a patient to another HAAD licensed receiving facility and who is
responsible to ensure all documentation requirements are completed as per the
requirements set out in this Standard.
3.12 Transfer Coordinator Receiving (TCRC): A designated individual from a HAAD
licensed receiving healthcare facility who has been given the responsibility to
coordinate the reception of a patient from another HAAD licensed healthcare
facility (transferring) and ensure all documentation requirements are completed
as per the requirements set out in this Standard
3.13 Patient preference: Individual's expression of desirability or value of one course of
action, outcome, or selection in contrast to others.
3.14 Transfer agreement: A written agreement between a HAAD licensed healthcare
facility and an interfacility transport service that has been licensed by HAAD with
specified scope of service.

Page 3 of 13
4.0 Duties for Healthcare Facilities
4.1 HAAD licensed healthcare facilities are required to manage emergency
response in an inpatient setting, outpatient setting, ambulance service
setting and when patient transfer is needed to an appropriate healthcare
facility. Healthcare Facilities and Professionals shall comply with the following
duties:
4.1.1 Have policies and procedures in place and the appropriate level of
resources (professionals, medical needs and supplies and access to
ambulance services) to provide high quality safe management and
care of patients in accordance to the requirements set out in this
Standard;
4.1.2 Comply with all policies and standards for medication management,
supply and control of their use and ensure:
4.1.2.1 Sufficient stocks of required medications and medical
equipment are available as per the healthcare providers
license and scope of services and minimum requirements
set out in this Standard.
4.1.2.2 All Medications and Medical devices are compliant with the
Ministry of Health, UAE, Administrative Circulars 27 of
2005, 41 of 2008 and 001 of 2009;
4.1.2.3 Ensure Medical devices are maintained and quality tested
according to manufacturer’s specifications;
4.1.2.4 Ensure the secure management of narcotics, controlled and
semi-controlled medication;
4.1.2.5 Cooperate with HAAD authorised auditors, as and
when requested for inspections and audits by HAAD; and
4.1.2.6 Comply with HAAD requirements for managing patient
medical records, maintaining confidentiality, privacy and
security of patient information and educating patients and
fulfilling the requirements of patient consent and patients’
rights and responsibilities charter.
4.1.3 Undertake and document the outcomes of assessment of the
patient’s condition to ensure:
4.1.3.1 that patients are stabilised prior to transfer;
4.1.3.2 that potential risks of deterioration during transfer are
evaluated against the potential benefits; and
4.1.3.3 the most suitable receiving healthcare facility has been
identified for the management of the patient’s needs
(specialised expertise and equipment shall also be
considered) and condition (urgency for definitive
management);
4.1.4.4 Document the outcome of the transfer and evaluate
the process to demonstrate the effectiveness of the referral
and transfer system;
4.1.4 Cooperate with and endeavour to accept transferred patients and
assist with coordination and identification of bed availability prior to
transfer, and subsequently be accountable for fulfilling all duties
necessary to receive the patient, once bed availability is confirmed

Page 4 of 13
 and transfer is accepted, and provide appropriate, safe and high
quality care;
4.1.4.1 Ensure that when a patient is identified as requiring transfer
to another facility, that the responsible treating physician
supported by a multidisciplinary team assesses the patient’s
needs so as to:
4.1.4.1.1determine whether the admitting facility is able to
provide the required level and type of service and care
needed; or identify a facility that can offer the requisite
scope of services and care needed, has the mix of
specialised staff, resources and equipment that are
appropriate to meet patient needs;
4.1.5 Develop, implement and monitor an emergency response system for
patients and include the following:
4.1.5.1 Set out in writing the details of the system in a policy and
standard operating procedures for emergency response, the staffing
requirements and documentation for emergency response, audit and
training, the coordination and transfer of patients (including the
requirement to have in place transfer agreements with respective
healthcare providers), monitoring the outcome of patient transfers,
identifying issues, and risks associated with transfers and process for
rectifying identified issues, managing risk;
4.1.5.1.1 A medical oversight mechanism shall be in place
to oversee, manage and monitor the effectiveness of the
emergency system and to affect corrective actions and
continuous improvements where necessary;
4.1.6 Where the responsible healthcare provider decides to transfer the
patient as determined by the patient’s case assessment, they must
ensure that all triaging and initial assessment of findings are
documented at the time of referral and an appropriate ambulance
with appropriate staff are made available as per the patient needs.
4.1.7 In cases where a patient receives specialised treatment at a receiving
facility, and is to be transferred back to the referring facility, the
referring and receiving facilities must continue to coordinate to
ensure this takes place in a seamless manner to meet the patient’s
needs are met;
4.1.8 Provide emergency services and care in accordance with the
requirements of this Standard and with relevant HAAD Clinical Care
Standards, as applicable, and ensure their practices are consistent
with internationally recognised evidence based clinical care
practices;
4.1.9 Comply with HAAD requirements on adverse events management
and reporting, managing patient medical records, including
developing effective recording systems, maintaining patient records
including consent, protecting the confidentiality, privacy and security
of patient information and educating patients and fulfilling the
requirements of patients’ rights and responsibilities charter; and
4.1.10 Comply with HAAD requests to inspect and audit records and
cooperate with HAAD authorised auditors.

Page 5 of 13
5. Role of HAAD
5.1 To set and define the required Standards, including but not limited to:
laying out the parameters and service specifications for emergency
preparedness, emergency service requirements, professional requirements,
coordination and communication requirements and reporting requirements;
5.2 Audit and inspect providers and monitor compliance with the requirements
of this Standard and other relavant HAAD Policies and Standards;
5.3 Request improvement actions from healthcare providers in cases where
non-compliance with this Standard is identified;
5.4 Where risks to patient safety and quality are identified impose sanctions for
breaches to HAAD regulations;
5.4 Analyse data reported on interfacility transfer and emergency transfer
cases and their management, identify trends and improvement needs,
disseminate and publish reports; and
5.5 Request, at its discretion, through the HAAD Operations Centre,
service information such as information on bed availability, patient acuity (and
during transfer), staff and vehicle capacity to facilitate the safe and effective
transfer of patients.

6. Enforcement and Sanctions

6.1 HAAD licensed healthcare providers must comply with the requirements of this
Standard, the HAAD Standard Provider Contract and the HAAD Data Standards.
HAAD may impose sanctions in relation to any breach of requirements under this
standard in accordance with Chapter IX, HAAD Policy on Complaints,
Investigations, Regulatory Action, and Sanctions, The Healthcare Regulator Policy
Manual.

7. Standard 1. Requirements for All Healthcare Facilities

7.1 Resources, equipment, medications and professional requirements
7.1.1 HAAD licensed healthcare facilities shall as a minimum:
7.1.1.1 Adhere to the minimum requirements as listed in
Appendix 2 and 3 for inpatient setting and Appendix 4 for
outpatient setting.
7.1.1.2 Adhere to the minimum requirements as listed in
Appendices 5 -13 for the provision of ambulance services and
Interfacility transfer;
7.1.1.3 Adhere to the following:
7.1.1.3.1 A list and description of all medications and their
review date;
7.1.1.3.2 Appropriate adult and paediatric dosing
references
(drug product leaflet);
7.1.1.3.3 Expiry dates of the medications;
7.1.1.3.4 List of staff who fulfil basic or advanced
emergency response
7.1.2 Other than the oxygen, all emergency medications, equipment and
supplies must be safely and securely stored together in a purpose-
designed, storage unit and/or portable emergency kit;

Page 6 of 13
 7.1.3 The emergency medications must be readily accessible, in a visible
location, and where a storage unit is utilised, be in a container
secured with a break-away lock or as an emergency kit that is secure;
7.1.4 The contents of the emergency storage unit and/or portable
emergency kit may only be serviced with medication and equipment
by appropriately licensed and privileged healthcare professionals
based on the specific scope of service provided at the facility and the
expectation of emergency patient needs;
7.1.5 The contents of the emergency storage unit and/or portable
emergency kit must be:
7.1.5.1 Inspected and/or tested at least once a month and after
each use by a licensed healthcare professional with relevant
qualifications and training;
7.1.5.2 An inspection log must be attached to the emergency
storage unit and/or portable emergency kit with clear dates of
inspections, replacements and name of the individual undertaking
the inspection; and
7.1.5.3 Replenished, maintained and serviced according to
medications expiry and equipment service requirements as per the
manufacturer’s recommendations.
7.2 The HAAD licensed Healthcare Facility must ensure that they operate and have in
place arrangements for access to and/or use of ambulances services to transfer
patients to an appropriate level of care provided by a HAAD licensed
Healthcare facility.
7.3 The HAAD licensed Healthcare facility must ensure:
7.3.1 All healthcare professionals are licensed by HAAD; and
7.3.2 Emergency interventions are provided by a HAAD licensed healthcare
professionals with the appropriate emergency skills and training
requirements;

8. Standard 2. Inpatient and Outpatient Healthcare Facility Service Requirements

8.1 All healthcare professionals employed in an inpatient healthcare
facility shall be trained to Basic Life Support level (BLS) with at least one
member within the department who is trained to Advanced Life Support (ALS) or
Paediatric Advanced Life Support (PALS) level in accordance with an internationally
recognised training programme
8.1.1Training refresher courses shall be undertaken annually;
8.2 All healthcare professionals employed at outpatient healthcare facility
shall be trained to Basic Life support level (BLS) in accordance with an
internationally recognised training programme.
8.2.1 Small outpatient facilities such as dental clinics or home healthcare services
should undertake a Primary Survey for Respiratory Arrest (BLS) until the patient is
stabalised for transfer to a suitable setting;
8.2.1.1 Equipment in the portable kit shall include but not be limited to AED,
Epipen (or Epi 1:1000), hydrocortisone, anti-histamine and aspirin (tablets);
8.2.2 Training refresher courses shall be undertaken annually;
8.3 All healthcare professionals dealing with paediatric patients shall be
trained to deliver Paediatric Life Support (PALS), in accordance with an

Page 7 of 13
 internationally recognised training programme;
8.3.1Training refresher courses shall be undertaken annually;
8.4 The healthcare facility must maintain records of training (including refresher
training) and provide evidence of the delivery of such training when
requested by HAAD.
8.4.1Healthcare Facilities must ensure that they have the appropriate number of
Basic and Advanced ambulances to meet the patient case mix, operational requirements of the
clinical services provided by that facility. Where a healthcare facility sources ambulance services
from a third party, it is the healthcare facilities responsibility to ensure that the appropriate level
of ambulance service is provided to meet the patient needs.
8.5 A Healthcare Facility may utilise the Abu Dhabi universal emergency services
where for example:
8.5.1 they meet the HAAD requirement for provision of patient transfer capacity
and capability in accordance with their license and scope of services and
privileges;
8.5.2 capacity and/or capability of their own ambulance service does not allow
for emergency patient transfer;
8.5.2.1 patient acuity does not permit the required professional and skill mix
to transfer the patient.
8.5.3 ambulance services are en-route and/or prioritised elsewhere;

9. Standard 3. Interfacility Patient Transfer Service Requirements

9.1 Healthcare providers shall develop, implement, monitor and review their system
for patients requiring interfacility transfer. The system must be designed to
provide high quality and safe standards of care before, during and after transfer
suited to the level of patient need. The system must comprise of medical
oversight to ensure favourable patient outcomes. As a minimum, written
policies and standard operating procedures/protocols must cover the following
elements:
9.1.1 Patient assessment, classification and need for transfer and care
management;
9.1.2 Identification and selection of a receiving facility that is appropriate to
the patient’s needs, taking into account the scope of service, including
need for specialised services, capacity and capability of the receiving
facility;
9.1.3 Use of HAAD licensed ground ambulance and assignment of a transfer
coordinator to manage the co-ordination of interfacility patient transfers
as set out in Appendices 5-13;
9.1.3.1 It is the responsibility of the Healthcare Provider to
determine the category of healthcare professional to be
assigned the role of the transfer coordinator.
9.1.4 Use of HAAD Licensed healthcare professionals with suitable credentials
and training to form a transfer or retrieval team to manage the needs
of the patient.
9.1.5 To ensure accurate and efficient communication processes between
Healthcare facilities and HAAD operation Centre, Healthcare facilities
shall:
9.1.5.1 Assign and manage an emergency number to facilitate direct

Page 8 of 13
 communication between hospital transfer coordinators; and
9.1.5.2 Assign a dedicated email (non-personal address) for the
allocated transfer coordinator to facilitate direct
communication between hospital transfer coordinators and
with HAAD
9.1.6 All healthcare professionals involved in the provision of care during
interfacility patient transfer must have Transport knowledge and skills
comprising of:
9.1.6.1 Radio and communication technology;
9.1.6.2 Safety operations;
9.1.6.3 Transport equipment;
9.1.6.4 Documentation including patient care records
(manual/electronic)
9.1.6.5 Transport logistics;
9.1.6.6 Facility transfer standard operating procedures/protocols;
9.1.6.7 Physician verbal orders, patient positioning during transport
for safety and accessibility;
9.1.6.8 Relevant emergency training according to basic or
advanced transfer as per HAAD requirements including but
not limited to: BLS, ACLS, ATLS and PALS.
9.1.6.9 All healthcare professionals involved in the provision of
basic transfer shall have the knowledge and skills and meet
the minimum requirements including but not limited to:
intravenous insertion, monitoring and maintenance, all forms
of medication administration, airway management, ECG
monitoring, defibrillation, cardio-version, transcutaneous
pacing and offer basic intervention as needed.
9.1.6.10 All healthcare professionals involved in the provision of
advanced transfer shall have the knowledge and skills and
meet the minimum requirements including but not limited
to: ACLS, ATLS, PLS, advanced airway management,
ventilator management, all forms of medication
management, circulatory management and support and
have the ability to continuously monitor and assess the
patient’s condition and intervene as needed.
9.2 It is the responsibility of management and staff of the referring
healthcare facility to ensure and check that the ambulance is well
equipped and all equipment are functional to respond to medical
emergencies during the patient transfer;
9.2.1 The referring healthcare facility management will be
responsible for any delay in transporting the patient to the receiving
healthcare facility once the approval from the receiving facility is
obtained;
9.2.2 After each patient transfer by ambulance it is the responsibility of
the ambulance service provider to dispose of all used disposable and
contaminated items and replace them with new items. All other
items including emergency medicines should be replaced or
refurbished accordingly and in compliance with regulation;

Page 9 of 13
 9.3 Documentation related to transfers must be recorded including expected
timeframes between referring and receiving facility in addition to the
following:
9.3.1 Transfer requests from requesting provider;
9.3.2 Acceptance from receiving providers (at least specialist
level physician) prior to patient transfer;
9.3.3 Discussion with patient and/or relatives and consent for transfer.
Where a patient and/or their family reject the transfer, a form including Left
Against Medical Advice (LAMA) section must be signed by the patient or
his/her legally authorised guardian/family member;
9.3.4 Discussion with and instructions given to the escorting healthcare
professionals;
9.3.4.1 Evidence of agreement between hospitals regarding the
transferring of the patient back to the referring hospital
upon fulfilling the transfer purpose;
9.3.4.2 Post transfer feedback form to be sent back to referring
facility within one week of patient discharge (Appendix 13);
9.3.4.3 Details of any electronic records or documentation sent
to the receiving facility and acknowledgements of their
receipt;
9.3.4.4 Documentation related to the transferred patient that is
not available at the time of transfer but is to be sent within five (5)
working days (e.g. laboratory results);
9.3.4.4.1Management and safe and secure storage of all patient
related documentation and forms, including Referring
facility reporting form, receiving facility reporting form,
record of transfer, Post transfer feedback form and any
other related forms such as consents forms, left against
medical advice form.
9.3.4.4.2 The full address regarding the location of referring
Healthcare facility, demographic data and condition of
patient must be properly communicated to the
universal emergency service staff.

10. Standard 4. Ambulance Service Requirements

10.1 Ambulance service providers will be licensed by HAAD to provide
either basic and/or advanced emergency service as set out in Appendix 14.
10.2 All HAAD licensed Ambulance Service Providers must:
10.2.1 Ensure all ambulance vehicles have passed the regulatory vehicle
registration requirements of respective Abu Dhabi Government Authorities,
including those of Abu Dhabi Police Vehicles and Drivers Licensing
Department, road and service worthiness and safety, crash test certification and
vehicle drivers have the appropriate registration and license for the use of
ambulances;
10.2.2 Ensure that ambulance vehicle drivers have the appropriate
license to drive ambulances and that they have completed training in
road safety rules and regulations as specified by the respective Abu
Dhabi Government Authority;

Page 10 of 13
 10.2.3 Ensure all newly acquired ambulance vehicles comply with
CEN 1789 best safety standards, meet UAE regulations, HAAD requirements
for licensing and certification and have relevant and up to date
documentation/certificate and registration/license to ensure vehicle and
driver safety including but not limited to the following:
10.2.3.1 Weight
10.2.3.1.1 It is essential that the manufacturer’s
weight limit (GVW) is not exceeded when the vehicle is
in full operational mode. Documentation of this
requirement must be provided to HAAD.
10.2.3.1.2 Markings
10.2.3.1.2.1 The base colour of the ambulance
must be in line with HAAD requirements; and
10.2.3.1.2.2 High visibility markings and
emergency light must be in line with HAAD
requirements.
10.2.4 When installing medical and/or emergency devices and
equipment into an ambulance, ensure that installation is done by a
licenced company/organisation that complies with this Standard and
CEN1789, and that such installation does not adversely impact
the operability of the ambulance or any of it equipment;
10.2.5 Ensure ease of accessibility to installed devices and equipment for
servicing, maintenance and/or replacement;
10.2.6 Retain documentation from the original vehicle equipment
manufacturer confirming the acceptability of any modifications for
healthcare performed on an ambulance vehicle, including equipment
devices for healthcare for at least the lifespan of the vehicle;
10.2.7 Changes in ambulance configuration can be made as long as they
remain consistent with CEN1789 Standards manufacturer’s specifications
10.2.8 Have in place and maintain a record of routine performance checks
of ambulance vehicles as requested by HAAD and in accordance with the
manufacturer’s recommendations including but not limited to:
10.2.8.1 Having user manuals and service schedules for all medical
devices and equipment easily accessible to paramedics and
ambulance staff;
10.2.8.2 Ensuring vehicles are maintained in clean and sanitary
condition, and that a detailed facility policy and procedures
governing infection control the cleaning and sanitation of
ambulances and equipment is developed, implemented and its
implementation monitored;
10.2.8.3 Ensuring appropriate medical supplies are available and
replenished to ensure minimum level maintained at all times and
supplies are suitable for the care provided, as per the approved
scope of services;
10.3 Healthcare providers are responsible for ensuring that ambulance services (be it
through facility owned and/or contracted services), deliver safe, effective and
high quality services.
10.3.1 HAAD Licensed Healthcare Facilities may obtain ambulance services
through third party ambulance service providers under contractual or

Page 11 of 13
 partnership arrangements that stipulate the type of practice, privilege and
patient acuity to be transported; and
10.3.2 The Healthcare Provider must have in place a written
contract/agreement with a third party service provider to manage emergency
transfer where it does not have ambulance services. This contract/agreement
must be presented during facility licensure.
10.4 Ambulance Service Providers must ensure the following requirements are in
place:
10.4.1 Governance: necessary formal arrangements to govern and ensure
quality improvement, assurance and safety and performance of
ambulance service provision is suitable for the range and type of services
provided by the healthcare facility.
10.4.2 Staffing: All healthcare professionals must adhere to their approved
privileges in accordance with the HAAD Clinical Privileging framework,
their respective professional scope of practice and scope of service.
10.4.3 Service Provision: Service provision will be determined by HAAD
licensure, service scope of practice and privileges granted by the
healthcare provider.
10.4.4 Ambulance Service Provider shall ensure they have in place and
make use of information management systems including but not limited
to: Telecommunications, Emirates Medical Radio Communication
Systems (Tetra), Electronic Patient Care Reporting (EPCR) system and have
the technological ability to communicate at different frequencies as
required.
10.4.5 Ambulance Service Provider shall ensure:
10.4.5.1 They have in place an Emergency Medical Dispatch (EMD)
system that is functioning with sufficient Telecommunication
equipment (wireless radio) for communication and a
means for receiving calls for the service.
10.4.5.2 They are equipped with a Mobile Tracking Device (MTD)
system for emergency management and tracking.
10.4.6 Response: Healthcare facilities must utilise their own ambulances in the
first instance (see section 8.5) and where necessary ensure they respond
major incident as part of a system wide response as directed by HAAD
emergency operation centre.
10.4.7Monitoring: Ambulance service providers must ensure they are able to
assess and monitor the patient’s condition with an integrated monitoring
system capable of four lead ECG, SpO2, PetCO2 and NIBP with 12 lead
ECG capability, if ALS is present.
10.4.8 Clinical Supplies and Staffing: It is the responsibility of the Healthcare
Provider to ensure adequate staffing, equipment and medical supplies are
functional for all medical emergency transfer.
10.4.8.1 Restocking of the Ambulance: Ambulance Service Providers
must ensure they dispose all used disposable and contaminated items
and replace them to a minimal level once transfer has been
completed. All other items including emergency medicines should
be replaced or refurbished as per best practice and UAE
regulations. This includes updating medication stock and
medication management and administration of

Page 12 of 13
 controlled/narcotic medications as per HAAD
requirements. The Ambulance Service Provider must:
10.4.8.1.1 Ensure disposable medical waste is managed in
accordance with HAAD Policies and Standards
governing medical products and medical waste disposal
and EHSMS; and
10.4.8.1.2 Ensure that all medical equipment where possible shall
be disposable or single patient use in accordance with
international best practice for infection control.
10.4.9 Adhere to the latest JRCALC (UK Ambulance Clinical Practice
Guidelines) or equivalent internationally recognised ambulance
Clinical Practice Guidelines.

11. Standard 5. Ambulance Service Performance

11.1 HAAD requires ambulance service providers to maintain a record of Key
Performance Indicators (KPIs) as noted in Appendix 15.
11.1.1 Healthcare Facilities must monitor and analyse the performance of
ambulance services and ensure actions are taken to improve service
performance, quality, patient safety and patient outcomes;
11.1.2 Healthcare Facilities must report the number of Ambulances they have,
their classification and Type (CEN 1789 B or C) to HAAD on a quarterly
basis to opcenter@haad.ae
11.1.3 Healthcare facilities must submit monthly reports to HAAD
all interfacility patient transfers to emergency.review@haad.ae
11.1.4 Healthcare facilities must submit Jawda performance metrics for
ambulance service performance on a quarterly basis to quality@haad.ae

Page 13 of 13