May 16, 2009 When a hospital’s emergency department is overcrowded with seriously sick and injured patients, it may “go on diversion,” re-routing ambulances to other emergency departments. But the benefits of “diversion” are largely unproven. Often those emergency departments are just as crowded, and the greater distance to that other hospital can worsen the condition of some patients.
In 2006, a group of teaching hospitals in Boston agreed to stop going on diversion for two weeks, to see if eliminating diversion would cause any problems. A team of researchers led by Dr. Franklin Friedman at Tufts Medical Center examined what happened during these two weeks, as compared to the two weeks right before the “no diversion” experiment.
The researchers found that no significant problems arose. There were no changes in the numbers of patients seen in the emergency departments, or in the amount of time the ambulances crews had to wait at the hospital for emergency department staff to take over patient care – and the amount of time that admitted patients had to wait in the emergency department for a hospital bed actually decreased by about 18 minutes.
The state of Massachusetts, noting the findings from this study, has now ended the practice of ambulance diversion state-wide as of 1/1/09, in part due to the results of this study.
The presentation, entitled “A Trial To End Ambulance Diversion In Boston,” will be given by Dr. Franklin Friedman in the Emergency Medical Services / Out-of-Hospital forum at the 2009 SAEM Annual Meeting at the Sheraton New Orleans on May 16, 2009. Abstracts are published in Vol. 16, No. 4, Supplement 1, April 2009 of Academic Emergency Medicine, the official journal of the Society for Academic Emergency Medicine.
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