St. Louis hospital cuts ER diversions

Administrators at inner city-based St. Louis University Hospital were troubled by their rate of ambulance diversion. For 2003, St. Louis University ranked third among 22 area hospitals for diversions, rerouting ambulances 660 hours due to ER overcrowding and resources drained by its status as a Level One trauma center. But after instituting some process changes designed to assess ER conditions and free up beds, the hospital has been able to cut that figure dramatically.

The hospital developed a method for rating conditions in the ER objectively, lessening staff's incentive to divert ambulances solely as a gut reaction to perceived volume. It developed a special waiting area for patients waiting to go home, freeing up beds they would have otherwise occupied. And St. Louis created a system alerting administrators as to availability of beds hospital-wide, letting them know when to move patients out of beds aggressively. Thanks to these efforts, things changed. This year diversions fell to 176 hours between January and the end of July, according to the St. Louis Post-Dispatch.

Get more background on the hospital's diversion strategy:
- read this piece in the St. Louis Post-Dispatch