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Internet-accessible emergency department workload information reduces ambulance diversion.
Prehosp Emerg Care. 2005 Jul-Sep; 9(3):285-91.PE

Abstract

OBJECTIVE

To determine the effect of pre-emptive ambulance distribution based on the implementation of a real-time, Internet-accessible emergency department (ED) workload schematic and prehospital Australasian Triage Scale (ATS) allocations on ambulance diversion in Western Australia.

METHODS

Comparison of July-December 2002 and July-December 2003 metropolitan Perth ED cubicle occupancy, ambulance diversion, ambulance distribution, and ambulance unloading delays at four inner and four outer metropolitan EDs.

RESULTS

Ambulance diversion fell from 1,788 hours in 2002 to 1,138 hours in 2003 (p < 0.001) despite an increase in mean weekly ED cubicle occupancy from 31 patients (95% confidence internal [CI] 29-33) in 2002 to 39 patients in 2003 (95% CI 36-43, p < 0.001). Inner metropolitan ED ambulance attendances fell 2.7% from 27,475 in 2002 to 26,743 in 2003, and outer metropolitan correspondingly rose from 5,877 to 6,628 ambulance attendances (p < 0.001). Unloading delays were similar in 2002 (219, 0.66%) and 2003 (223, 0.67%, p = 0.84); however, median duration of unloading delays increased from 38 minutes (interquartile range [IQR] 18-68) in 2002 to 50 minutes (IQR 25-108) in 2003 (p < 0.001).

CONCLUSIONS

The implementation of pre-emptive ambulance distribution using Internet-accessible ED information and prehospital ATS allocations was associated with reduced ambulance diversion, probably consequent upon the redistribution of ambulances from inner to outer metropolitan EDs. The rise in ED cubicle occupancy between the study periods suggests that this approach to reducing ambulance diversion should be viewed only as complementary to direct efforts to reduce ambulance diversion by improving hospital inpatient flow and the balance between acute and elective hospital inpatient accommodation.

Authors+Show Affiliations

Sprivulis P
Department of Health, Western Australia, Perth. psprivulis@ihi.org
Gerrard B
No affiliation info available

MeSH

AmbulancesBed OccupancyCommunity Health PlanningCrowdingEfficiency, OrganizationalEmergency Service, HospitalHospital Information SystemsHumansInternetPatient TransferRetrospective StudiesTriageUrban Health ServicesWestern AustraliaWorkload

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16147477

Citation

Sprivulis, Peter, and Brett Gerrard. "Internet-accessible Emergency Department Workload Information Reduces Ambulance Diversion." Prehospital Emergency Care, vol. 9, no. 3, 2005, pp. 285-91.
Sprivulis P, Gerrard B. Internet-accessible emergency department workload information reduces ambulance diversion. Prehosp Emerg Care. 2005;9(3):285-91.
Sprivulis, P., & Gerrard, B. (2005). Internet-accessible emergency department workload information reduces ambulance diversion. Prehospital Emergency Care, 9(3), 285-91.
Sprivulis P, Gerrard B. Internet-accessible Emergency Department Workload Information Reduces Ambulance Diversion. Prehosp Emerg Care. 2005 Jul-Sep;9(3):285-91. PubMed PMID: 16147477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Internet-accessible emergency department workload information reduces ambulance diversion. AU - Sprivulis,Peter, AU - Gerrard,Brett, PY - 2005/9/9/pubmed PY - 2005/12/13/medline PY - 2005/9/9/entrez SP - 285 EP - 91 JF - Prehospital emergency care JO - Prehosp Emerg Care VL - 9 IS - 3 N2 - OBJECTIVE: To determine the effect of pre-emptive ambulance distribution based on the implementation of a real-time, Internet-accessible emergency department (ED) workload schematic and prehospital Australasian Triage Scale (ATS) allocations on ambulance diversion in Western Australia. METHODS: Comparison of July-December 2002 and July-December 2003 metropolitan Perth ED cubicle occupancy, ambulance diversion, ambulance distribution, and ambulance unloading delays at four inner and four outer metropolitan EDs. RESULTS: Ambulance diversion fell from 1,788 hours in 2002 to 1,138 hours in 2003 (p < 0.001) despite an increase in mean weekly ED cubicle occupancy from 31 patients (95% confidence internal [CI] 29-33) in 2002 to 39 patients in 2003 (95% CI 36-43, p < 0.001). Inner metropolitan ED ambulance attendances fell 2.7% from 27,475 in 2002 to 26,743 in 2003, and outer metropolitan correspondingly rose from 5,877 to 6,628 ambulance attendances (p < 0.001). Unloading delays were similar in 2002 (219, 0.66%) and 2003 (223, 0.67%, p = 0.84); however, median duration of unloading delays increased from 38 minutes (interquartile range [IQR] 18-68) in 2002 to 50 minutes (IQR 25-108) in 2003 (p < 0.001). CONCLUSIONS: The implementation of pre-emptive ambulance distribution using Internet-accessible ED information and prehospital ATS allocations was associated with reduced ambulance diversion, probably consequent upon the redistribution of ambulances from inner to outer metropolitan EDs. The rise in ED cubicle occupancy between the study periods suggests that this approach to reducing ambulance diversion should be viewed only as complementary to direct efforts to reduce ambulance diversion by improving hospital inpatient flow and the balance between acute and elective hospital inpatient accommodation. SN - 1090-3127 UR - https://www.unboundmedicine.com/medline/citation/16147477/Internet_accessible_emergency_department_workload_information_reduces_ambulance_diversion_ DB - PRIME DP - Unbound Medicine ER -