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Related Experiment Videos

Community trial to decrease ambulance diversion hours: the San Diego county patient destination trial.

Gary M Vilke1, Edward M Castillo, Marcelyn A Metz

  • 1County of San Diego, Division of Emergency Medical Services, San Diego, CA, USA. gmvilke@ucsd.edu

Annals of Emergency Medicine
|October 2, 2004
PubMed
Summary
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A community intervention effectively reduced ambulance diversion, ensuring more patients reached their requested emergency departments. This approach decreased diverted patients and bypass hours, improving emergency medical services.

Area of Science:

  • Emergency Medicine
  • Public Health Policy
  • Healthcare Systems Management

Background:

  • Ambulance diversion is a significant challenge in emergency care, leading to patient access issues and fragmented care.
  • Lack of medical records and transfer delays exacerbate care complexities when patients cannot reach their intended facilities.

Purpose of the Study:

  • To evaluate the effectiveness of a community-wide intervention aimed at reducing ambulance diversion.
  • To assess the impact of revised ambulance diversion guidelines on patient transport and emergency department bypass hours.

Main Methods:

  • A community intervention was implemented across a county with 2.8 million residents.
  • Ambulance diversion guidelines were revised for all ambulance agencies and emergency departments.

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  • Key outcome measures, including patient transports, diversions, and bypass hours, were compared across pre-trial, trial, and post-trial periods.

    • Main Results:

    • A significant reduction in patients not reaching their requested emergency department due to diversion was observed during the trial and post-trial periods compared to the pre-trial period.
    • Average monthly hours on ambulance diversion also significantly decreased during the trial and post-trial periods.
    • The intervention involved voluntary participation from emergency departments.

    Conclusions:

    • A voluntary, community-wide strategy effectively reduced hospital emergency department diversion.
    • The intervention successfully increased the number of ambulance patients reaching their requested facilities.