Our Overburdened Emergency Departments - Relieving the Squeeze Through Ambulance Diversion

2.50
Hdl Handle:
http://hdl.handle.net/10755/162947
Type:
Presentation
Title:
Our Overburdened Emergency Departments - Relieving the Squeeze Through Ambulance Diversion
Abstract:
Our Overburdened Emergency Departments - Relieving the Squeeze Through Ambulance Diversion
Conference Sponsor:Emergency Nurses Association
Conference Year:2002
Author:Presley, Diane, RN, MSN
P.I. Institution Name:Seton Medical Center
Contact Address:1201 W. 38th Street, Austin, TX, 78705, USA
Contact Telephone:(512)324-1031
Co-Authors:Gail Robinson, RN
Clinical Topic: Emergency Department (ED) overcrowding has multiple effects including: risks for poor patient outcomes; prolonged pain; long waits; increased dissatisfaction; decreased staff productivity; and increased frustration. Strain intensifies in winter months when overcrowding and ambulance diversion explode into public view. Overcrowding results from complex interwoven issues; increased acuity of patients; increased volume; reduced access to primary care; managed care problems; hospital bed shortages; and limited nursing staff. These are also factors when patients clamor for service. Implementation: The development of the diversion hospital system, diverting patients away from urban trauma centers during periods of especially high volumes, provides sporadic relief. Austin, Texas and Travis County include two large matrix hospital networks, which equal eight hospitals. These institutions service a 13-county area that includes a population over 1,500,000. A city interagency disaster team created/implemented a citywide diversion system. Two geographically contiguous in-network hospitals cannot simultaneously be "On Diversion." "On Diversion" is further classified by specific patient groups, which are determined by facilities. If the identified hospital is "On Diversion," the patient will be transported to another hospital of patient preference strongly utilizing "same network facilities." Paramedics in charge will decide if emergency status patients will be transported to the closest facility if immediate assistance is required regardless of diversion status. A Mass Casualty Incident will demand that all hospitals automatically re-open. Outcomes: In November 2001 ambulance diversion plans were implemented. Discussions held at public meetings noted the effect to ambulance providers, neighboring hospitals and EMS dispatch centers. The goals for standardization of diversion were successful: a) improved communication between hospitals; b) consistent protocols for EMS Field Responders; and c) increased community satisfaction with ability to accommodate patients for evaluation. These developments suggest the Austin diversion system is successful in providing brief respite time for EDs. Recommendations: The ambulance-diversion system has proven to be initially successful, but will not completely solve the overcrowding problem. As team re-evaluation occurs, variations in the system may be needed. These related approaches are temporary stop-gap mechanisms, rather than long-term solutions. [Clinical Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleOur Overburdened Emergency Departments - Relieving the Squeeze Through Ambulance Diversionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162947-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Our Overburdened Emergency Departments - Relieving the Squeeze Through Ambulance Diversion</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Presley, Diane, RN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Seton Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1201 W. 38th Street, Austin, TX, 78705, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(512)324-1031</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Dpresley@seton.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Gail Robinson, RN</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Emergency Department (ED) overcrowding has multiple effects including: risks for poor patient outcomes; prolonged pain; long waits; increased dissatisfaction; decreased staff productivity; and increased frustration. Strain intensifies in winter months when overcrowding and ambulance diversion explode into public view. Overcrowding results from complex interwoven issues; increased acuity of patients; increased volume; reduced access to primary care; managed care problems; hospital bed shortages; and limited nursing staff. These are also factors when patients clamor for service. Implementation: The development of the diversion hospital system, diverting patients away from urban trauma centers during periods of especially high volumes, provides sporadic relief. Austin, Texas and Travis County include two large matrix hospital networks, which equal eight hospitals. These institutions service a 13-county area that includes a population over 1,500,000. A city interagency disaster team created/implemented a citywide diversion system. Two geographically contiguous in-network hospitals cannot simultaneously be &quot;On Diversion.&quot; &quot;On Diversion&quot; is further classified by specific patient groups, which are determined by facilities. If the identified hospital is &quot;On Diversion,&quot; the patient will be transported to another hospital of patient preference strongly utilizing &quot;same network facilities.&quot; Paramedics in charge will decide if emergency status patients will be transported to the closest facility if immediate assistance is required regardless of diversion status. A Mass Casualty Incident will demand that all hospitals automatically re-open. Outcomes: In November 2001 ambulance diversion plans were implemented. Discussions held at public meetings noted the effect to ambulance providers, neighboring hospitals and EMS dispatch centers. The goals for standardization of diversion were successful: a) improved communication between hospitals; b) consistent protocols for EMS Field Responders; and c) increased community satisfaction with ability to accommodate patients for evaluation. These developments suggest the Austin diversion system is successful in providing brief respite time for EDs. Recommendations: The ambulance-diversion system has proven to be initially successful, but will not completely solve the overcrowding problem. As team re-evaluation occurs, variations in the system may be needed. These related approaches are temporary stop-gap mechanisms, rather than long-term solutions. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:54Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:54Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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