Guy Clifton

Health Care Quality

Communications — Fri, 19 Sep 2008 05:00:00 -0400

A New America Event
09/19/2008 - 10:00am

Whether you are insured or uninsured, the serious quality problems in the American health care system affect you. There are many excellent health care providers in America, yet there are too many preventable mistakes and too few efforts to coordinate patient care. Our Emergency Departments are over-burdened and inefficient and many Americans experience unequal health care outcomes because of race, ethnicity, and income. Fundamental changes are needed in health care delivery in the United States.… more

New Report Says Ambulance Diversions are Just another Symptom of a Struggling Health System

Communications — Thu, 04 Sep 2008 08:39:00 -0400

U.S. hospitals routinely turn ambulances away in an emergency -- further proof that our health system is in need of comprehensive reforms, according to a report released today by the Health Policy Program at the New America Foundation.

In the report entitled, "Ambulance Diversions: What They Are, Why We Care, and What To Do," Guy Clifton, MD, neurosurgeon and Physician Advisor to the New America Foundation, suggests that ambulance diversions are a result of an increased reliance on Emergency Departments (EDs) for primary care (especially by the uninsured), inefficiencies in hospital practice, and bed capacity that is inadequate or unstaffed.

"The pervasiveness of ambulance diversions puts us all at risk. Comprehensive health reforms that both incentivize hospitals to improve the quality of their practice and ensure all Americans have health coverage, would reduce the frequency of ambulance diversions and make sure our emergency system functions at its highest level when patients need it the most," said Dr. Clifton.

"Ambulance diversions are further evidence that covering all Americans is a necessary step towards improving the quality of patient care in the U.S.," Clifton continued.

An ambulance diversion occurs when a hospital ED cannot care for additional emergency patients. When a hospital is "on diversion" it redirects ambulances from their ED to another hospital or medical facility. One ambulance is diverted every minute in the U.S. according to the Institute of Medicine.

"Ambulance Diversions: What They Are, Why We Care, and What To Do"

Ambulance diversions pose a health threat to Americans needing emergency care. Anyone, regardless of insurance status, can be diverted from a hospital in an emergency. Ambulance diversions impact both emergency trips to the hospital and transports from one hospital to another.
Standardizing ambulance diversion criteria and covering the uninsured could help reduce ambulance diversions. Standard criteria for when a hospital can put itself on diversion should be established and adopted by all hospitals. These 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.

The large number of uninsured patients causes increased strain on already over-taxed emergency departments. Making sure all Americans have quality, affordable health coverage will help keep patients out of the hospital for non-emergent treatment and allow EDs to function more efficiently.

For more information visit the New Health Dialogue blog at www.newhealthdialogue.org .

Contact:
Elizabeth Carpenter
New America Foundation
401-529-9379 (cell)
202-986-2700 (office)
carpenter@newamerica.net

Ambulance Diversions

Health Policy — Wed, 03 Sep 2008 08:26:00 -0400

Every minute in the United States, an ambulance is turned away from a hospital because of a practice known as ambulance diversion. Diverting ambulances away from emergency departments (EDs) poses a serious threat to the health outcomes of both the insured and uninsured population. Ambulance diversions also indicate a struggling health system in need of comprehensive delivery system reforms.

What is an Ambulance Diversion?

An ambulance diversion occurs when a hospital ED cannot care for additional emergency patients. When a hospital is “on diversion” it redirects ambulances from their ED to another hospital or medical facility.

Why Do Diversions Matter?

Ambulance diversions pose a health risk to anyone who needs immediate medical attention. Furthermore, ambulance diversions are an indication that individuals are using EDs for their primary care, and that hospitals have inadequate bed capacities, and/or are being poorly managed.

What Can We Do to Fix This Problem?

There are two major possible policy solutions for ED diversion:

Standardizing Ambulance Diversion Criteria
Covering the Uninsured

For the full text of the issue brief, click here.

Guy Clifton

Operations — Fri, 01 Feb 2008 18:58:00 -0500

Former Senior Research Fellow, Health Policy ProgramAs a former Senior Research Fellow for the Health Policy Program at the New America Foundation, Guy Clifton focused on health care reform to cover the uninsured and on reform of the delivery system to reduce cost and improve quality. In addition, Dr. Clifton acted as the Health Policy Program’s… more