Tags

Type your tag names separated by a space and hit enter

The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time.
Ann Emerg Med. 2013 Mar; 61(3):303-311.e1.AE

Abstract

STUDY OBJECTIVE

Massachusetts became the first state in the nation to ban ambulance diversion in 2009. It was feared that the diversion ban would lead to increased emergency department (ED) crowding and ambulance turnaround time. We seek to characterize the effect of a statewide ambulance diversion ban on ED length of stay and ambulance turnaround time at Boston-area EDs.

METHODS

We conducted a retrospective, pre-post observational analysis of 9 Boston-area hospital EDs before and after the ban. We used ED length of stay as a proxy for ED crowding. We compared hospitals individually and in aggregate to determine any changes in ED length of stay for admitted and discharged patients, ED volume, and turnaround time.

RESULTS

No ED experienced an increase in ED length of stay for admitted or discharged patients or ambulance turnaround time despite an increase in volume for several EDs. There was an overall 3.6% increase in ED volume in our sample, a 10.4-minute decrease in length of stay for admitted patients, and a 2.2-minute decrease in turnaround time. When we compared high- and low-diverting EDs separately, neither saw an increase in length of stay, and both saw a decrease in turnaround time.

CONCLUSION

After the first statewide ambulance diversion ban, there was no increase in ED length of stay or ambulance turnaround time at 9 Boston-area EDs. Several hospitals actually experienced improvements in these outcome measures. Our results suggest that the ban did not worsen ED crowding or ambulance availability at Boston-area hospitals.

Links

Publisher Full Text
Aggregator Full Text
Aggregator Full Text

Authors+Show Affiliations

Burke LG
Beth Israel Deaconess Medical Center, Boston, MA, USA. lgburke@bidmc.harvard.edu
Joyce N
No affiliation info available
Baker WE
No affiliation info available
Biddinger PD
No affiliation info available
Dyer KS
No affiliation info available
Friedman FD
No affiliation info available
Imperato J
No affiliation info available
King A
No affiliation info available
Maciejko TM
No affiliation info available
Pearlmutter MD
No affiliation info available
Sayah A
No affiliation info available
Zane RD
No affiliation info available
Epstein SK
No affiliation info available

MeSH

AmbulancesBostonCrowdingEmergency Service, HospitalHealth PolicyHospitalizationHumansLength of StayPatient DischargePatient TransferRetrospective StudiesTime Factors

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

23352752

Citation

Burke, Laura G., et al. "The Effect of an Ambulance Diversion Ban On Emergency Department Length of Stay and Ambulance Turnaround Time." Annals of Emergency Medicine, vol. 61, no. 3, 2013, pp. 303-311.e1.
Burke LG, Joyce N, Baker WE, et al. The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time. Ann Emerg Med. 2013;61(3):303-311.e1.
Burke, L. G., Joyce, N., Baker, W. E., Biddinger, P. D., Dyer, K. S., Friedman, F. D., Imperato, J., King, A., Maciejko, T. M., Pearlmutter, M. D., Sayah, A., Zane, R. D., & Epstein, S. K. (2013). The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time. Annals of Emergency Medicine, 61(3), 303-e1. https://doi.org/10.1016/j.annemergmed.2012.09.009
Burke LG, et al. The Effect of an Ambulance Diversion Ban On Emergency Department Length of Stay and Ambulance Turnaround Time. Ann Emerg Med. 2013;61(3):303-311.e1. PubMed PMID: 23352752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of an ambulance diversion ban on emergency department length of stay and ambulance turnaround time. AU - Burke,Laura G, AU - Joyce,Nina, AU - Baker,William E, AU - Biddinger,Paul D, AU - Dyer,K Sophia, AU - Friedman,Franklin D, AU - Imperato,Jason, AU - King,Alice, AU - Maciejko,Thomas M, AU - Pearlmutter,Mark D, AU - Sayah,Assaad, AU - Zane,Richard D, AU - Epstein,Stephen K, Y1 - 2013/01/24/ PY - 2011/12/02/received PY - 2012/08/23/revised PY - 2012/09/11/accepted PY - 2013/1/29/entrez PY - 2013/1/29/pubmed PY - 2013/5/2/medline SP - 303 EP - 311.e1 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 61 IS - 3 N2 - STUDY OBJECTIVE: Massachusetts became the first state in the nation to ban ambulance diversion in 2009. It was feared that the diversion ban would lead to increased emergency department (ED) crowding and ambulance turnaround time. We seek to characterize the effect of a statewide ambulance diversion ban on ED length of stay and ambulance turnaround time at Boston-area EDs. METHODS: We conducted a retrospective, pre-post observational analysis of 9 Boston-area hospital EDs before and after the ban. We used ED length of stay as a proxy for ED crowding. We compared hospitals individually and in aggregate to determine any changes in ED length of stay for admitted and discharged patients, ED volume, and turnaround time. RESULTS: No ED experienced an increase in ED length of stay for admitted or discharged patients or ambulance turnaround time despite an increase in volume for several EDs. There was an overall 3.6% increase in ED volume in our sample, a 10.4-minute decrease in length of stay for admitted patients, and a 2.2-minute decrease in turnaround time. When we compared high- and low-diverting EDs separately, neither saw an increase in length of stay, and both saw a decrease in turnaround time. CONCLUSION: After the first statewide ambulance diversion ban, there was no increase in ED length of stay or ambulance turnaround time at 9 Boston-area EDs. Several hospitals actually experienced improvements in these outcome measures. Our results suggest that the ban did not worsen ED crowding or ambulance availability at Boston-area hospitals. SN - 1097-6760 UR - https://www.unboundmedicine.com/medline/citation/23352752/The_effect_of_an_ambulance_diversion_ban_on_emergency_department_length_of_stay_and_ambulance_turnaround_time_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(12)01533-8 DB - PRIME DP - Unbound Medicine ER -