QUALITY: Ambulance Diversions Show Need for Reform (Part 3)

Last week we posted (here and here) about our new issue brief on ambulance diversions. Here are a few thoughts about what we can do to fix the problem, which is a threat to all of us, regardless of our wealth or insurance status. Shutting emergency departments, even briefly, to ambulance traffic is a a sign of the strain on our overall health care system.

One part of the solution is to set standard criteria for when a hospital can put itself on diversion. Criteria might include: percentage of hospital beds currently in use, the number of staff on duty, and the number of people in the ED waiting room. Hospital accountability for reporting and abiding by diversion standards could be tied to federal funding. For instance, failure to report diversion rates in a timely manner would jeopardize hospital funding. It would help if we could do a comprehensive national study to assess hospital capacity, and diversions' impact.

The second part is a bigger challenge. We need to cover the uninsured. As we've said, the 46 million uninsured are not the only source of strain on the emergency system, but it's a big factor. Making sure all Americans have quality, affordable health coverage will help keep patients out of the hospital for non-emergency treatment and allow EDs to function at their highest level when patients need them the most.

We'll write more about the emergency care crisis (and the mirror image, the primary care crisis) soon. Stay tuned.