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Impacts of an EMS Hospital Liaison Program on Ambulance Offload Times: A Preliminary Analysis

Published online by Cambridge University Press:  02 December 2021

Becca M. Scharf Open the ORCID record for Becca M. Scharf [Opens in a new window] ,
Eric M. Garfinkel ,
David J. Sabat ,
Eric B. Cohn ,
Robert C. Linton  and
Matthew J. Levy
Becca M. Scharf*
Affiliation:
Howard County Department of Fire and Rescue Services, Marriottsville, MarylandUSA
Eric M. Garfinkel
Affiliation:
Howard County Department of Fire and Rescue Services, Marriottsville, MarylandUSA Department of Emergency Medicine, Johns Hopkins University, Baltimore, MarylandUSA
David J. Sabat
Affiliation:
Howard County Department of Fire and Rescue Services, Marriottsville, MarylandUSA
Eric B. Cohn
Affiliation:
Howard County Department of Fire and Rescue Services, Marriottsville, MarylandUSA
Robert C. Linton
Affiliation:
Department of Emergency Medicine, Johns Hopkins University, Baltimore, MarylandUSA
Matthew J. Levy
Affiliation:
Howard County Department of Fire and Rescue Services, Marriottsville, MarylandUSA Department of Emergency Medicine, Johns Hopkins University, Baltimore, MarylandUSA
*
Correspondence: Becca Scharf, MSc 2201 Warwick Way Marriottsville, Maryland 21104 USA E-mail: bscharf@howardcountymd.gov
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Abstract

Introduction:

Ambulance patients who are unable to be quickly transferred to an emergency department (ED) bed represent a key contributing factor to ambulance offload delay (AOD). Emergency department crowding and associated AOD are exacerbated by multiple factors, including infectious disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic. Initiatives to address AOD present an opportunity to streamline ambulance offload procedures while improving patient outcomes.

Study Objective:

The goal of this study was to evaluate the initial outcomes and impact of a novel Emergency Medical Service (EMS)-based Hospital Liaison Program (HLP) on ambulance offload times (AOTs).

Methods:

Ambulance offload times associated with EMS patients transported to a community hospital six months before and after HLP implementation were retrospectively analyzed using proportional significance tests, t-tests, and multiple regression analysis.

Results:

A proportional increase in incidents in the zero to <30 minutes time category after program implementation (+2.96%; P <.01) and a commensurate decrease in the proportion of incidents in the 30 to <60 minutes category (−2.65%; P <.01) were seen. The fully adjusted regression model showed AOT was 16.31% lower (P <.001) after HLP program implementation, holding all other variables constant.

Conclusion:

The HLP is an innovative initiative that constitutes a novel pathway for EMS and hospital systems to synergistically enhance ambulance offload procedures. The greatest effect was demonstrated in patients exhibiting potentially life-threatening symptoms, with a reduction of approximately three minutes. While small, this outcome was a statistically significant decrease from the pre-intervention period. Ultimately, the HLP represents an additional strategy to complement existing approaches to mitigate AOD.

Keywords

ambulance offload delayCOVID-19crowdingemergency departmentEmergency Medical Services
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 1 , February 2022 , pp. 45 - 50
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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