Biweekly Briefing Articles

Ambulance Patient Offload Time: A Critical Deadline is Just the Beginning

A major deadline looms for hospitals and our partners. On Sept. 1, hospitals are required to submit their Ambulance Patient Offload Time (APOT) reduction protocol under Assembly Bill (AB) 40. The standard is 30 minutes, 90% of the time for general, acute care hospitals with emergency departments (EDs).

Is your hospital getting ready to submit the protocol? It’s crucial that we prioritize this activity to ensure timely and effective patient care, minimize the strain on our emergency services, and comply with the regulatory requirements. To be successful, we must be proactive in developing strategies to streamline the patient offloading process while keeping our eye on the big picture — maintaining optimal patient care and operational efficiency within our hospitals.

AB 40 requires hospitals to include mechanisms in the protocol that will improve hospital operations and reduce APOT.

There are many reasons for patient offload delays — ED overcrowding, staffing shortages, communication challenges with emergency medical services, surges in patient volume, and more. Additionally, thousands of patients remain hospitalized every day due to discharge challenges such as limited post-acute care capacity and insurance company delays and denials. These factors result in patients occupying inpatient beds for days or weeks longer than necessary, reducing availability for new ED patients and delaying ambulance admissions.

APOT is a complex issue, resulting from systemic challenges across the entire health care delivery system and collaboration on solutions is essential. That is why we are convening a regional workgroup with hospitals, fire departments, ambulance providers, and county emergency medical services. It will take all of us working together to find solutions to the many issues contributing to delays.

Education is a key factor for success. CHA has just released materials to support hospitals as they work to develop their APOT reduction protocol and incorporate it into organizational strategy. The members-only educational brief and on-demand presentation includes best practices, key deadlines, and requirements for hospitals. I hope you will make use of these valuable materials.

The Sept. 1 submission deadline is not the end of the story. We should always be working to improve hospital operations and collaborating with our partners in health care in a never-ending pursuit of quality, equitable care for our communities.