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Emergency Department Overcrowding and Ambulance Diversion

Emergency Department Overcrowding and Ambulance Diversion. Mary L. Kopp, BSN, RN Nurse Manager for Emergency Services Scottsdale Healthcare Shea. Development of a Community Plan. Historical-- the need to understand diversion Community Concern Diversion had a “negative connotation”

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Emergency Department Overcrowding and Ambulance Diversion

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  1. Emergency Department Overcrowding and Ambulance Diversion Mary L. Kopp, BSN, RN Nurse Manager for Emergency Services Scottsdale Healthcare Shea

  2. Development of a Community Plan • Historical-- the need to understand diversion • Community Concern • Diversion had a “negative connotation” • Understanding that diversion was not just a hospital problem • Arizona Emergency Medical Services (AEMS) Assigned a Diversion Task Force • Provide timely transport of patients • Deliver quality care to our community • Determine when hospitals reached saturation Mary Kopp

  3. Develop Diversion Guidelines • State the purpose • Determines Standard of Care • Identify the goal • Consistent definitions of terminology • Establish categories • ED/Trauma Saturation • Facility Internal Disaster • Determine facility/pre-hospital responsibilities • Authorizing/Monitoring of diversion • *Prompted national search for computerized technology Mary Kopp

  4. Computerized Technology • Automated Internet System • Partnership between Arizona Healthcare Hospital Association and Phoenix Fire • Program needed to include • Assignment of diversion • How many hospitals are on diversion • Clarifying operational issues • Tracking of diversion hours by facility • Integration of the EMSystem • Real time diversion status • Cancellation of Pre-hospital Diversion • Community need to access emergency care • System overload- sector 2/3 capacity Mary Kopp

  5. Automatic Cancellation of Diversion • Quantifiable Data • Determine a saturation percentage • Determine whom dispatch would place on automatic cancellation of diversion • Development of the AEMS Facility Diversion Worksheet • List factors of why emergency departments go on diversion • Assign number to quantify factors Mary Kopp

  6. Which Hospital Comes Up On Diversion? • Geographic sector assignments for Central Arizona • Understanding guidelines of 2/3 system overload • % calculated by each hospital • Which facility stays on diversion, for how long • Rotation of all facilities until all facilities have returned to normal • Need for individual hospital strategies for saturation Mary Kopp

  7. Continue to Develop Quality Reports Research Support State Wide Implementation Bioterrorism Surveillance Future On-line Capability Mary Kopp

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