Massachusetts To End Emergency Department Ambulance Diversions

Main Category: Primary Care / General Practice
Also Included In: Public Health
Article Date: 17 Sep 2008 - 10:00 PDT

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The Massachusetts Department of Public Health last week ordered all hospital emergency departments in the state to halt diverting ambulances to other hospitals to relieve overcrowding by January 2009, the Boston Globe reports. Hospitals on diversion status only accept trauma and burn patients and walk-ins, but patients with other ailments are diverted to a different hospital.

According to Paul Dreyer, director of health care safety and quality for MDPH, diverting ambulances shifts overcrowding to other hospitals; sends patients away from hospitals where their medical records and regular physicians are located; increases time spent in ambulances; and unnecessarily occupies emergency vehicles. Dreyer also said that diversions have not addressed overcrowding.

Under the new rule, diversions will be prohibited in nearly all cases except in the event of a serious internal emergency, such as a fire. A recent experiment in which Boston hospitals stopped diversions for two weeks found that patient wait times or "boarding" of patients in ED hallways did not increase. The experiment also found that ED staff developed strategies to treat patients quickly and admit them into the hospital. Dreyer said diversions might have distracted hospitals from addressing the underlying reasons for overcrowding.

Alasdair Conn, chief of emergency services for Massachusetts General Hospital, said the new rule likely will be a serious challenge for hospitals that have long relied on the practice (Kowalczyk, Boston Globe, 9/13).

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