Policy:
Access to quality emergency care is
a critical part of the local health care system in Iredell County. Hospital
resources, including emergency services, may occasionally become overwhelmed and
may not be able to provide optimal patient care. In these situations, it is
necessary to have a policy that addresses the diversion of ambulance patients
from local hospitals when resources are limited.
Purpose:
·
To identify situations in which a hospital’s resources are
not available and temporary ambulance diversion is required.
·
To notify the local EMS system and hospital personnel of such
occurrences and to provide prompt notification when the situation that caused
diversion has been resolved. This notification must occur through Iredell County
EMS via way of Iredell County ECOM.
·
To regularly review and update the hospital’s diversion
status.
·
To provide for the safe, appropriate, and timely care of
patients who continue to enter the EMS system during periods of diversion.
·
To explore solutions that addresses the causes of diversion
and implement policies that minimize the need for diversions.
·
To continuously review policies and guidelines governing
diversion through the Iredell County EMS Quality Management Committee.
Procedure:
1.
Should diversion become necessary, a designated representative from each
diverting hospital will contact Iredell County EMS via way of Iredell County
ECOM and advise what type of patients are being diverted to other facilities.
Minimum information required includes:
2.
Each diverting hospital will promptly contact ECOM and provide
notification when diversion status has ended.
3.
For the purposes of this policy, diversion will be defined in one four
different categories:
·
Critical Care: All critical care patients will
be transported to the next closest, appropriate hospital. Includes ICU, CCU,
major trauma, etc.
·
Routine Admission: Known, or suspected,
routine admissions will be transported to the next closest, appropriate
hospital.
·
Selective: EMS must contact the diverting
hospital prior to transport so the base physician can determine if the
patient’s needs exceed available resources.
·
Complete: The diverting hospital cannot
accept any ambulance patients.
4.
If more than one hospital goes on diversion simultaneously, EMS personnel
will notify the closest, appropriate medical facility and advise of intent to
transport. EMS personnel will then transport to that medical facility.
5.
If a patient, patient’s physician, or patient’s healthcare power of
attorney, requests transport to a hospital on diversion, advise the responsible
party of that facility’s diversion status.
6.
If a patient, patient’s physician, or patient’s healthcare power of
attorney demands transport to a hospital on diversion, contact the base
physician at the diversion hospital and advise him/her of the responsible
party’s demand and request permission to transport.
7.
EMS personnel may override a hospital’s diversion status only if
bypassing a facility on diversion will jeopardize a patient’s condition. Any
decision to override will be automatically subject to internal administrative
and medical review and will be forwarded the Quality Management Committee for
review also.