The Effect of Decreasing Ambulance Diversion Hours on Emergency Department Interfacility Transfers

2.50
Hdl Handle:
http://hdl.handle.net/10755/163056
Type:
Presentation
Title:
The Effect of Decreasing Ambulance Diversion Hours on Emergency Department Interfacility Transfers
Abstract:
The Effect of Decreasing Ambulance Diversion Hours on Emergency Department Interfacility Transfers
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Metz, Marcelyn, RN, BS, CEN
P.I. Institution Name:County of San Diego, Division of EMS
Title:Quality Assurance Specialist
Contact Address:6255 Mission Gorge Road, San Diego, CA, 92120, USA
Contact Telephone:(619) 285-6429
Purpose: When emergency departments (ED) divert ambulances, patients may not go to their pay requested
facility or where their physicians and records are located. One consequence of ambulance diversion
is the need to transfer some patients back to their "home" institutions if they require admission. This
can result in duplication of evaluation and studies, time wasted by staff arranging transfers, and the use of
scarce ED beds and staff resources by patients waiting for interfacility transportation. The purpose of this
study was to determine whether a community trial to reduce diversion by transporting patients directly to
their requested facility would affect the number of interfacility transfers.
Design/Sample/Setting: This study used a retrospective cohort review of ambulance transport records
for all patients who were transferred from the nine study hospitals by ambulance from August 1 -
November 30, 2002. The nine community hospitals in San Diego County serve a resident population of 3
million covering 4,300 square miles.
Methodology: ED interfacility transport records were evaluated to determine the number of patients who
were transferred from an emergency department to another hospital because of payer request. The data
collection was done two months before and two months after the initiation of a prehospital study intervention
designed to decrease ambulance diversion and improve patient transport to their requested facility.
Data collected included total ambulance transports, total number of interfacility transfers (IFT), total
IFTs for level of care reasons (trauma, burn, pediatrics, psychiatric), total IFTs for payer request, total IFTs
for payer request that arrived by ambulance, ED census, and hospital admissions. Comparisons were made
using paired t-tests.
Results: The number of ambulance transports increased from 19,321 during the pre-trial period to 19,716
during the post-trial period (p > 0.05).The total IFTs decreased from 1,162 to 1,003 (p = 0.002). Total IFTs
for payer request decreased from 575 to 445 (p = 0.002). Total IFTs for payer request that came in via
ambulance decreased from 440 to 276 (p = 0.02). There were no significant differences between total
IFTs for level of care, ED census, and total patients admitted.
Emergency nurses spend hours caring for and preparing patients for interfacility transfers.
Patients awaiting transfer compound emergency department overcrowding and ambulance diversion. The
effort to send ambulance patients to requested facilities initially was shown to significantly decrease the
number of patients who later required interfacility transport for payer request. [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.titleThe Effect of Decreasing Ambulance Diversion Hours on Emergency Department Interfacility Transfersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/163056-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Effect of Decreasing Ambulance Diversion Hours on Emergency Department Interfacility Transfers</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">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Metz, Marcelyn, RN, BS, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">County of San Diego, Division of EMS</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Quality Assurance Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6255 Mission Gorge Road, San Diego, CA, 92120, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(619) 285-6429</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">marcy.metz@sdcounty.ca.gov</td></tr><tr><td colspan="2" class="item-abstract">Purpose: When emergency departments (ED) divert ambulances, patients may not go to their pay requested<br/>facility or where their physicians and records are located. One consequence of ambulance diversion<br/>is the need to transfer some patients back to their &quot;home&quot; institutions if they require admission. This<br/>can result in duplication of evaluation and studies, time wasted by staff arranging transfers, and the use of<br/>scarce ED beds and staff resources by patients waiting for interfacility transportation. The purpose of this<br/>study was to determine whether a community trial to reduce diversion by transporting patients directly to<br/>their requested facility would affect the number of interfacility transfers.<br/>Design/Sample/Setting: This study used a retrospective cohort review of ambulance transport records<br/>for all patients who were transferred from the nine study hospitals by ambulance from August 1 -<br/>November 30, 2002. The nine community hospitals in San Diego County serve a resident population of 3<br/>million covering 4,300 square miles.<br/>Methodology: ED interfacility transport records were evaluated to determine the number of patients who<br/>were transferred from an emergency department to another hospital because of payer request. The data<br/>collection was done two months before and two months after the initiation of a prehospital study intervention<br/>designed to decrease ambulance diversion and improve patient transport to their requested facility.<br/>Data collected included total ambulance transports, total number of interfacility transfers (IFT), total<br/>IFTs for level of care reasons (trauma, burn, pediatrics, psychiatric), total IFTs for payer request, total IFTs<br/>for payer request that arrived by ambulance, ED census, and hospital admissions. Comparisons were made<br/>using paired t-tests.<br/>Results: The number of ambulance transports increased from 19,321 during the pre-trial period to 19,716<br/>during the post-trial period (p &gt; 0.05).The total IFTs decreased from 1,162 to 1,003 (p = 0.002). Total IFTs<br/>for payer request decreased from 575 to 445 (p = 0.002). Total IFTs for payer request that came in via<br/>ambulance decreased from 440 to 276 (p = 0.02). There were no significant differences between total<br/>IFTs for level of care, ED census, and total patients admitted.<br/> Emergency nurses spend hours caring for and preparing patients for interfacility transfers.<br/>Patients awaiting transfer compound emergency department overcrowding and ambulance diversion. The<br/>effort to send ambulance patients to requested facilities initially was shown to significantly decrease the<br/>number of patients who later required interfacility transport for payer request. [Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:38:49Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:38:49Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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