Some busy hospitals say they must turn away ambulances. But diverting ambulances can cost patients precious minutes in an emergency. journalsentinel
The practice disproportionately affects patients who are sicker, older and poorer, studies have found. One study found when a nearby safety-net hospital closed to ambulances. Another study found African American patients had a greater chance of a fatal heart attack during times of diversion.
Nurses in different departments pointed fingers at each other because they couldn’t get rooms filled and emptied fast enough.In November 2000, for example, a 55-year-old woman died of a heart attack after she was turned away from Mount Auburn Hospital in Cambridge, the closest, best-equipped hospital to treat cardiac emergencies.
Many assumed the problem was because too many people were coming into the ER for bad colds, sprains and other minor issues — a misconception experts say remains today. “It was a broad coalition of leadership that accepted the fact that diverting patients was harmful to patient care and the ultimate responsibility lies with the hospitals,” Feldman said. “That is the initial fix for ambulance diversion and crowding — hospitals actually have to own the problem.”When Maryland created its color-coded system, the idea was that hospitals going on alert would be a rare event. At 8:30 p.m. on Sept.
The following day, Sinai Hospital was on yellow alert for much of the day, yet the emergency room waiting area was largely empty. Officials later said that patients are kept in other areas and the waiting area is not necessarily a sign of how busy they are. All told, between Saturday and Tuesday, two dozen hospitals went on more than 100 different alerts for a total of 760 hours. Several alerts lasted more than 24 hours straight.
When they do go to a hospital on alert, paramedics may face a long wait before they can get back on the road, which in turn can increase response times for other calls. “As the number of complex patient cases has increased at our hospital, our alert level has also increased,” a spokeswoman said in an emailed statement. “It’s like a game of whack-a-mole,” said Lisa Myers, a former official with the Maryland Institute for Emergency Medical Services Systems, the state agency that oversees paramedics statewide and the alert system. “You get one thing good and two more pop up.” Johns Hopkins Hospital in Baltimore is known for its advanced medical care and research.
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