Approach to decreasing emergency department ambulance diversion hours.

Area of Science:

• Emergency Medicine
• Healthcare Operations Research

Background:

• Ambulance diversion between neighboring emergency departments (EDs) can create an oscillatory phenomenon, where one hospital's diversion leads to increased traffic and subsequent diversion at another.
• This reciprocal effect strains healthcare resources and impacts patient access to emergency care.

Purpose of the Study:

• To test the hypothesis that one hospital avoiding diversion status can avert diversion needs in a neighboring facility.
• To evaluate the impact of a single ED's commitment to no diversion on ambulance traffic and diversion hours.

Main Methods:

• One emergency department (ED A) committed to a 1-week trial of no ambulance diversion, securing additional resources.
• Operations at the neighboring hospital (ED B) remained unchanged during the trial.
• Ambulance runs, ED census, and diversion hours were compared for the weeks before, during, and after the trial period.

Main Results:

• No significant differences were observed in ambulance runs or ED census at either hospital during the trial.
• A dramatic reduction in diversion hours was observed: from 19.7 to 1.4 hours at ED A and 27.7 to 0 hours at ED B (p < 0.05).
• These reductions were significant compared to the weeks preceding and following the trial.

Conclusions:

• A single institution's commitment to avoid ambulance diversion can decrease reciprocal diversion effects.
• This strategy effectively reduces the need for diversion at neighboring facilities, potentially improving regional emergency care capacity.