Ambulance diversion that results from the overcrowding of emergency departments is a serious issue, not only in California, but in many parts of the United States as well. Diversion occurs when a hospital emergency department is unable to provide care for additional patients and redirects ambulances to other hospitals nearby. Ambulance diversion has a negative impact on patient outcomes, patient safety, continuity of care, and surrounding hospitals. The California HealthCare Foundation retained The Abaris Group to measure and track ambulance diversion in California and collect and analyze corresponding data on emergency department (ED) demand and capacity. This data includes utilization rates, licensed treatment beds and their utilization, and total emergency medical services transports. Called the California ED Diversion Project, the study also involved the formation of a one-year, multi-region, multi-hospital collaborative, intended to help reduce diversion hours and act as a diversion-reduction model for the state as a whole. In addition, the project inventoried best and promising practices to assist hospitals in improving flow and capacity. The study found that when hospitals and their local emergency medical services agency (LEMSA) are focused and united in reducing diversion, employing a collaborative process and best practices can aid in reducing ambulance diversion, improving patient flow, and opening communication among participants. All of the hospitals in the collaborative experienced a significant reduction of diversion hours during the collaborative time period. This issue brief provides an overview of ambulance diversion throughout the United States and in California, and summarizes the work completed on The California ED Diversion Project. It finds that while diversion is typically a symptom of a community experiencing considerable stress as a result of diminishing hospital capacity, those with lower diversion rates do not necessarily have higher capacity or lower utilization. The collaborative model and best practices presented her offer useful tools to communities that are committed to reducing or eliminating diversion.
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)