Is There an Association Between Emergency Department Overcrowding and Emergency Medical Services Redirection?

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-03-01 DOI:10.1016/j.jemermed.2024.09.011

Kurien Mathews MD, Mukund Mohan MD, Paul Barbara MD, Arsalan Shawl DO, Norman Ng DO, Joseph Basile MD, Barry Hahn MD, Amin Mohamadi MD

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引用次数: 0

Abstract

Background

Emergency Medical Systems (EMS) has developed policies to manage patient flow. In New York City, these practices include both diversion and redirection. Currently, gaps in the literature exist regarding the correlation between emergency department (ED) operational metrics and EMS redirection triggers.

Objectives

This study analyzes the relationship between ED operational metrics and EMS redirection practices.

Methods

This single-center retrospective cohort analysis analyzed EMS patient transports from April 2021 to May 2022. Data on EMS redirection was obtained from Fire Department of New York (FDNY) notifications, and ED operational metrics were collected from the hospital's data repository. Metrics included ED length of stay, admission rates, and times from door-to-triage and door-to-room.

Results

During the study, 93,783 patient visits were recorded, with 22,734 (24%) transported by EMS. Redirection was activated on 250 days, predominantly on Mondays. A slight association was found between overall ED volume and redirection occurrences (OR 1.02), but no significant correlations were identified with other specific ED operational metrics.

Conclusions

Our findings indicate no substantial correlation between these practices and ED operational metrics. These results suggest a need for a paradigm shift toward more objective, data-driven measures to inform EMS redirection, ensuring decisions are grounded in the ED's actual operational capacity.

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine