R EDUCING A MBULANCE D IVERSION : A M ULTIHOSPITAL A PPROACH

Objective. To evaluate the impact of procedures for reducing ambulance diversion in the metropolitan area of Syracuse, New York. Methods. This was a retrospective review of procedures for reducing ambulance diversion at the system-wide and hospital-specific levels between January 1, 2001, and June 30, 2002. System-wide procedures involved exchange of information concerning diversion. Hospital-specific procedures involved implementation of additional planning and criteria for implementing ambulance diversion and development of additional patient care resources within the respective hospitals. Results. Between 2000 and 2001, hours on ambulance diversion for the combined Syracuse hospitals declined by 24.8%. Between January and June 2001 and 2002, hours on diversion declined by 33.6%. These reductions in diversion hours occurred as numbers of ambulance transports increased by 7% and numbers of emergency department visits increased by 5%. Conclusion. The study demonstrated that a combination of approaches can produce meaningful reductions of ambulance diversion at the community-wide and hospital-specific levels. It also demonstrated that substantial amounts of diversion time remained after these efforts, which must be addressed by payers and consumers.