Ambulance diversion reduction: the Sacramento solution

Ambulance Diversion Reduction and Elimination: The 3-2-1 Plan

“…A full description of the first phase of our region-wide AD reduction program has been published (20). As background for this current program, we present here a summary of the first phase program.…”

“…The DMC developed a uniform AD policy, implemented a computerized, region-wide monitoring system, regularly reviewed best practices, and tracked our results (20). With the recognition that AD is not just an ED problem, collaborative efforts like ours have been initiated between various health care entities to reduce AD in California (31).…”

“…Further examples of collaborative efforts elsewhere include spreading out the timing for elective admissions and procedures throughout the week and reducing door-to-doctor times through the implementation of a physician-led triage program (23). No single list of supplemental programs was implemented across the board at all 17 hospitals in our region, as each hospital selected the ones that were most effective for their own particular hospital (8,20). As is noted prominently in various studies, collaboration remains a key ingredient in sustaining successful, long-term AD reduction and eventual AD elimination (20)(21)(22)34,35).…”

“…No single list of supplemental programs was implemented across the board at all 17 hospitals in our region, as each hospital selected the ones that were most effective for their own particular hospital (8,20). As is noted prominently in various studies, collaboration remains a key ingredient in sustaining successful, long-term AD reduction and eventual AD elimination (20)(21)(22)34,35). We successfully utilized collaborative methods in our 3-2-1 Plan, which included multi-hospital efforts and the use of Internet tools that closely tied individual hospitals with their EMS providers to significantly reduce and eliminate AD.…”

“…That year, the first phase of a comprehensive, region-wide AD reduction program that specified explicit diversion criteria was developed and implemented. A description of the program's design, implementation, and outcomes through the end of 2003 has been previously published (20). The development of an organized regional plan and system for AD reduction was deemed an important first step towards a no-diversion policy (8).…”