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Ambulance Diversion: Ethical Dilema and Necessary Evil
Eric J Adkins1, Howard A Werman1
1Department of Emergency Medicine, The Ohio State University, Columbus, Ohio.
The American Journal of Emergency Medicine
|March 25, 2015
Summary
Ambulance diversion creates ethical challenges. Addressing systemic operational inefficiencies, like patient boarding and ED congestion, offers a more impactful solution than simply restricting ambulance diversion.
Area of Science:
- Emergency Medicine
- Healthcare Ethics
- Health Systems Management
Background:
- Ambulance diversion poses ethical conflicts between patient rights and healthcare system demands.
- Maintaining emergency department (ED) patient safety is the primary driver for diversion requests.
Purpose of the Study:
- To explore the ethical considerations of ambulance diversion.
- To identify systemic solutions for mitigating the negative impacts of ambulance diversion.
Main Methods:
- Ethical principle analysis (autonomy, beneficence, justice, nonmaleficence).
- Discussion of operational factors contributing to ED congestion and patient boarding.
Main Results:
- Ambulance diversion involves a conflict between ethical principles.
- Operational inefficiencies, including patient boarding and ED crowding, are key drivers of diversion.
Conclusions:
- Developing policies for managing ambulance diversion during peak times is crucial.
- Addressing root causes of operational inefficiencies has a greater potential to reduce ambulance diversion than practice restrictions.
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