San Diego County Patient Destination Trial. Gary M. Vilke, M.D. Associate Professor of Clinical Medicine Interim Medical Director, San Diego County EMS. Acknowledgements. Edward M. Castillo, PhD Theodore C. Chan, MD Roneet Lev, MD Marcelyn A. Metz, RN Patricia A. Murrin, RN, MPH.
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San Diego County Patient Destination Trial
Gary M. Vilke, M.D.
Associate Professor of Clinical Medicine
Interim Medical Director, San Diego County EMS
Without the luxury of additional funding!
Vilke GM, Simmons C, Brown L, Skogland P, Guss DA: Approach to decreasing emergency department ambulance diversion hours. Acad Emerg Med 2001;8(5):526
Week Before Test Week Week After P-Value
Hosp A Diversion hrs19.61.4 39.4 p<0.05
Hosp A Diverted pts192 29 p<0.05
Hosp B Diversion hrs27.70 26.3 p<0.05
Hosp Diverted pts240 9 p<0.05
The oscillatory phenomenon, when one hospital went on diversion leading to a disproportionate flow of ambulance traffic to the neighboring facility that subsequently was forced to go on diversion, went away during the trial week.
Vilke GM, Loh A: A prospective study of minimizing ambulance diversion and its effect on emergency department census and hospital admissions. Prehosp Emerg Care 2003;7(1):171.
Week 1Week 2Week 3
No changes in numbers or percents of ED patients, med/surg admissions, ICU admissions.
There were significant decreases in patients being diverted and trends to decreased numbers of patient requiring interfacility transfer out.
No reported “unsafe” events in the ED during the trial week.