This is an issue of great concern to hospitals and the patients they serve. The bottom line: emergency department diversions are a symptom of a health care system under increasing stress.

  • During the 1990s, there were a growing number of emergency visits coupled with a shrinking number of health care workers, hospital emergency rooms and inpatient beds. The result: fewer - and much busier -- emergency departments grappling with more than 100 million emergency visits each year.

  • Clearly, the demand for emergency department services is on the rise. This is driven by an aging population (larger number of baby boomers in need of health care); changes in technology that allow us to save more lives and do more for more people; and a scaling back of managed care practices that previously restricted consumers' use of emergency departments.

  • Also, the emergency department serves a vital role in today's health care - serving as the safety net for uninsured and underinsured Americans. In effect, we're the sole source of health care and the emergency department is the only "family doctor" to many without insurance.
When a hospital cannot handle additional patients, the ED stops accepting patients via ambulance and patients are taken elsewhere. It's important to note that patients in urgent situations go to the closest hospital, even if the closest hospital is "on diversion" at that time.
Addressing this issue is about more than increasing the number of beds. A key to reducing diversions is to address the growing shortage of nurses, pharmacists, lab technicians and other hospital workers. On the national level, the AHA has helped develop legislation that will help attract and retain nurses and its blue-ribbon commission on the workforce shortage will issue a report this April. In our community…[insert personal example here about how your hospital is working to address the shortage locally].
The AHA is also trying to change burdensome regulations to let caregivers do what they signed up for -- caring for patients -- instead of pushing paper. A recent AHA survey found that workers complete one hour of paperwork for every hour spent providing patient care in the emergency department. That's simply unacceptable.
Clearly, the hospital field has many challenges. What you see happening in our emergency departments is a symptom of a stressed system. But it will take all of us - hospitals, physicians, nurses, educators, insurers and government - to heal the system.

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