Avoiding ambulance diversion: how does it work in the real world?

Recent blog discussions [1] [2] [3] [4] [5] about ambulance diversion have been generally critical of the Institute of Medicine’s unrealistic mandate for hospitals to avoid diversion and patient “boarding” by improving the efficiency of patient flow.

St. Louis area hospitals, feeling the crunch, offer a picture of what can realistically be achieved by the most aggressive bed management conceivable, as reported in today’s Post Dispatch. It’s an impressive effort---arguably the best hospitals could be expected to make. These folks are organized, and they’re trying everything in the book, from more efficient room cleaning to electronic tracking systems. The results? Although diversion lessened it still occurs at a rate of one to two hours per day in spite of some patient boarding.

When there’s no room there’s no room, and there’s only so much you can do.