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Related Experiment Videos

Ambulance diversion reduction: the Sacramento solution.

Pankaj B Patel1, Robert W Derlet, David R Vinson

  • 1Department of Emergency Medicine, The Permanente Medical Group, Sacramento, CA 95825, USA. pankaj.patel@kp.org

The American Journal of Emergency Medicine
|February 24, 2006
PubMed
Summary

A regional program significantly reduced ambulance diversion by 74%, decreasing hours from 23,785 to 7,143 annually. This success was achieved despite increased emergency department patient volumes and hospital admissions.

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Area of Science:

  • Health Services Research
  • Emergency Medicine
  • Public Health Policy

Background:

  • Ambulance diversion from emergency departments (EDs) is common in the US, potentially impacting patient care.
  • ED overcrowding is a known cause of ambulance diversion, but regional reduction strategies are less understood.

Purpose of the Study:

  • To describe the development, implementation, and impact of a region-wide program aimed at reducing ambulance diversion.
  • To assess the effectiveness of a comprehensive strategy in decreasing ambulance diversion hours on a large, urban scale.

Main Methods:

  • A 3-year study (January 2001–December 2003) in the greater Sacramento, California region.
  • Implementation of a comprehensive ambulance diversion reduction program on May 15, 2002.
  • Analysis of ambulance diversion hours from 17 participating hospitals as the primary outcome measure.

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Main Results:

  • Ambulance diversion hours decreased by 74% after program implementation, from a monthly average of -1428 hours.
  • Total annual diversion hours dropped from 23,785 in 2001 to 7,143 in 2003.
  • Reductions were observed despite increases in ED census, hospital admissions, EMS arrivals, inpatient census, and regional population.

Conclusions:

  • A comprehensive regional program successfully reduced ambulance diversion significantly in a large urban area.
  • This initiative offers a potential model for other regions lacking organized approaches to ambulance diversion.
  • Patient boarding in EDs remains a significant challenge for effective ambulance diversion reduction.