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Patient Distribution of an Urban-Rural Emergency Medical Services System

Published online by Cambridge University Press:  28 June 2012

Michael S. Jastremski*
Affiliation:
Director, Program in Emergency and Critical Care Medicine, University Hospital SUNY–Syracuse, Syracuse, N.Y.
Ronald J. Lagoe
Affiliation:
Executive Director, Hospital Executive Council, Syracuse, N.Y.
*
Michael S. Jastremski, MD, Director, Program in Emergency and Critical Care, SUNY–Syracuse, Health Science Center at Syracuse, 750 East Adams Street, Syracuse, NY 13210

Abstract

This study describes a series of mechanisms to alleviate overcrowding of hospital emergency departments by distributing critically ill patients among facilities with available resources. The initial mechanism, which was based on the availability of critical care beds, was used successfully between 1982 and 1986, but had to be abandoned when several new factors caused the availability of emergency department resources to become the limiting factor. A second approach, based on the availability of critical care and emergency department resources, produced limited success over a one-year period. The system currently in use, implemented in 1989, includes a distribution system based on the availability of emergency department resources and critical care beds, as well as a mechanism for diversion of ambulances to hospitals in neighboring counties at times of extremely high utilization. This experience demonstrates that mechanisms for planning the distribution of emergency and critically ill patients have universal applicability.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

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