Collaborative to decrease ambulance diversion: the California Emergency Department Diversion Project.

Area of Science:

• Emergency Medicine
• Healthcare Management
• Public Health Policy

Background:

• Ambulance diversion is a widespread issue affecting over half of US emergency departments (EDs).
• Diversion, intended for brief relief, has become routine for managing ED and hospital crowding.
• This practice impacts patient access and healthcare system efficiency.

Purpose of the Study:

• To evaluate the effectiveness of a collaborative initiative aimed at reducing ambulance diversion.
• To assess the impact of implementing best practices on patient flow within emergency services.

Main Methods:

• A pre/post study design was employed over two years (September 2006 - August 2008) in four California EMS regions.
• Hospitals implemented patient flow best practices focusing on input, throughput, and output.
• Monthly ED diversion data were collected and analyzed for changes.

Main Results:

• Total diversion hours decreased by 19.9% (17,618 pre-consortium vs. 14,117 post-consortium).
• The monthly average diversion hours reduced significantly by 292 hours (p = 0.007).
• Most months showed a decrease, with slight increases noted in January and February.

Conclusions:

• Collaborative efforts and the implementation of best practices can effectively decrease ambulance diversion.
• Sustained communication and focus on diversion are crucial for maintaining reduced hours.
• The findings support a model for improving ED patient flow and access.