Sep 13, 2008 6:25 pm US/Eastern
Mass. Hospitals Can't Send Ambulances Away
BOSTON (AP) ―
The state has ordered hospitals to stop the decades-old practice of turning away ambulances when their emergency rooms are overcrowded.
As of Jan. 1, hospitals must stop the temporary ER closures, called diversions, in almost all cases, the state Department of Public Health said on Friday.
The diversions can delay treatment and upset patients who aren't able to get care at their usual hospital. They also increase the time patients spend in ambulances and keep paramedics from other calls and shift crowding to other hospitals, Paul Dreyer, DPH director of health care safety and quality, told The Boston Globe.
The practice may give hospitals temporary breathing room, but it does nothing to address an underlying problem of too few open beds, Dreyer said. He said allowing hospitals to use ambulance diversion also may have removed their incentive to bring down internal backlogs.
The busy Massachusetts General and Brigham and Women's hospitals in Boston account for the majority of diversions statewide. Mass. General accounted for about 35 percent of the 1,826 hours hospitals closed their ERs to ambulances last year, Dreyer said. That means the hospital's ER was on diversion for the equivalent of almost a month.
Under the new policy, hospitals will be allowed to close their ERs to ambulances only if they have a serious internal emergency, such as a major fire, called a "code black."
Dr. Alasdair Conn, chief of emergency services at Mass. General, said the ban is undoubtedly better for patients.
"It makes no sense for a patient with 20 years of history at a hospital, where they had their surgery, where their EKG and other test results are, to have to go somewhere else," he said.
But he said the change will be a serious challenge for hospitals. Mass. General, which sees about 85,000 patients a year in its emergency room, is preparing for the change by focusing on ways to discharge patients from the hospital earlier, so beds can be freed for patients waiting in the ER.
Dr. Brien Barnewolt, chairman of emergency medicine at Tufts Medical Center in Boston, said Tufts stopped diversions in August. One change it made to free up beds so ER patients could be admitted more quickly was performing blood tests on overnight patients earlier in the morning. Doctors then receive test results faster and can discharge patients who are well enough to go home earlier in the day.
(© 2009 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)
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