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EMS Agency
The EMS Agency has started the following pilot projects:
Hospital diversions and ambulance destination decisions have an impact the San Francisco EMS System. Several Receiving Hospitals have high percentages of time on diversion while other hospitals have minimal diversion time. Ambulance diversion has been shown to contribute to longer prehospital treatment/transport times (potential delays to care), financial loss to hospitals, increased emergency department overcrowding, and amenable to system-driven improvement. The overall goal behind CADDiE Pilot Program is to test, on a small scale the impact of active, on-line Base Hospital Physician directed patient destination/distribution. A team of Base Hospital EM physician paired with a paramedic supervisor will be on duty during the project period (24 hours a day coverage for the program, with physician on-site coverage predominantly supplemented with on-call back up) to provide active direction/identification of destination for ambulances augmenting triage criteria in the current Ambulance Destination Policy 5000. The EMS System will work to compare the effectiveness of active ambulance destination determination during the 4-week trial period, and compare with current policy. The pilot project parameters will be measured with already existing data sets via ReddiNet diversion reports and First Watch CAD data. Results and analysis will be posted on the EMS Agency website, with the goal of introducing any resulting recommended policy revisions by 6 weeks following the pilot.