Emergency Department Diversions

"Community Influenza Outbreaks and Emergency Department Ambulance Diversion"
(2004) Annals of Emergency Medicine.
Influenza seasons have been found to be associated with increased ED ambulance diversion. The impact is significant but brief because there is little or no influenza activity most of the year. For every 100 cases of influenza in the community in a given week, ED ambulance diversion would be expected to increase by 2.5 hours/week at the average ED. During influenza seasons, 24.3% of observed weekly ambulance diversion was attributed to influenza.

"Emergency Department Overcrowding and Ambulance Diversion: The Impact and Potential Solutions of Extended Boarding of Admitted Patients in the Emergency Department"
(2006) Journal of Emergency Medicine
The 1986 Emergency Medical Treatment and Labor Act, the Balanced Budget Act of 1999, the increase in number of uninsured and underinsured persons, the limited availability of services offered off-hour by primary care physicians, and increased technology (CT, MRI, etc.) available only through the emergency department has contributed to an increase patient volume accompanied by a simultaneous decrease in reimbursement.

Institute of Medicine Reports on "The Future of Emergency Care"
(2006) Institute of Medicine
ENA actively participated in the development of these reports by providing staffing guidelines, position statements and 2001/2005 national benchmark guide data to the IOM.

"The Effect of Emergency Department Crowding on Paramedic Ambulance Availability"
(2004) Annals of Emergency Medicine.
This study reported a total of 21,240 incidents in which ambulances were out of service while waiting to transfer their patient to an open ED gurney. This accounted for 1 out of every 8 transfers. Of these delays, 8.4% were in excess of 1 hour, while the median delay time was 27 minutes. This decrease in ambulance availability may have a significant effect on the ability of the emergency medical services systems to provide timely responses to patient emergencies.