Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

How Much is that Patient in the Window?


This EMS Garage[1] had nothing to do with the song made famous by Patti Page, other than to provide a catchy title.

Winnipeg hospitals racked up a $60,000 bill last month after more than 400 ambulances were forced to wait upwards of 90 minutes to unload patients at emergency departments.[2]

All stick and no carrot. WWBBD – What Would Bugs Bunny Do?

There is even the possibility of a specialty in hallway medicine to deal with treating patients who never seem to make it into a hospital room.[3]

What can be done to improve the availability of ambulances?

The move is in response to reports that revealed one-third of Winnipeg ambulances are waiting to unload patients in emergency at any given time.[2]

What can be done to address the root of the problem?

Is this likely to backfire?

No.

This doesn’t have any potential for dramatic unintended consequences.[4]

Not even a little bit.

😳

Chris Montera
Rob Theriault
Greg Friese
Scott Kier
Anne Robinson

Footnotes:

[1] How Much is that Patient in the Window?: EMS Garage Episode 135
EMS Garage
Podcast

[2] City hospitals billed $60,000
Paramedic service charges for wait times

Winnipeg Free Press – PRINT EDITION
By: Jen Skerritt
Posted: 05/21/2011 1:00 AM
Article

[3] The emerging subspecialty of Hallway Medicine.
Freeman J.
CJEM. 2003 Jul;5(4):283-5. No abstract available.
PMID: 17472776 [PubMed – in process]

Free Full Text from CJEM with link to Free Full Text PDF Download.

[4] Unintended consequences
Wikipedia
Article

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Comments

  1. Boston, MA had a similar problem a few years ago. The famous Mass General Hospital redesigned their ambulance bay to allow for a heated hallway approaching triage so ambulance stretchers didn’t have to wait outside. It’s now over 100 feet long.
    The Department of Public Health investigated, and once concluding that there were more than sufficient resources (6+ Level I trauma centers in city limits). they put the onus on the hospitals themselves to solve the problem. They banned the hospitals from divering (rejecting) ambulances absent of a facility emergency (HazMat, loss of power, loss of water), and required patients to be seen by a nurse and given a bed within 20 minutes of arrival.
    Hospitals miraculously learned how to clear beds more effectively, admitting patients, allowing for rapid dispos, etc.
    Since then, problems have really disappeared. If you’d like more info (DPH policies, etc), email me.

  2. I heard somewhere that Detroit had a similar problem and they took another interesting approach, placing backboards on the floor of the hall, placing the patients on them, notifying the staff of their presence, and leaving them after giving report……but that’s just what I heard.

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