Emergency departments (EDs) serve their communities’ most urgent health care needs. They are often the first place patients — including those with behavioral health challenges or substance use disorders, as well as people experiencing homelessness — go to access health care.
At the same time, hospitals are working to reduce ambulance patient offload time (APOT) — work that is challenging due to ED overcrowding, staffing shortages, communication challenges with emergency medical services, surges in patient volume, and more.
APOT is a complex issue resulting from systemic challenges across the entire health care delivery system, and collaboration on solutions is essential for improvement. Under the mandates of Assembly Bill (AB) 40, the standard for offload time is 30 minutes, 90% of the time for general, acute care hospitals with EDs. Although the Sept. 1 deadline has passed for hospitals to submit their APOT reduction protocol to the Emergency Medical Services Authority, the work continues.
Two things to share in support of hospitals trying to meet this important goal:
First, the regional APOT Collaboration Workgroup is up and running with monthly meetings. The group is made up of fire chiefs, ambulance providers, county emergency medical services, and hospital members selected by the HASD&IC Board of Directors. The group is focused on three areas:
- Understanding the problem by assessing factors in pre-hospital and hospital operations that can delay offload time
- Collecting best practices that can be shared regionally so hospitals can benefit from each other’s experiences
- Helping San Diego County reduce APOT
We will update you on progress the group is making in the coming weeks and months.
Secondly, the California Hospital Association (CHA) has created a new support web page that houses a wide array of APOT resources for hospitals. CHA plans to regularly update the site with AB 40 regulation developments, news, advocacy materials, and information on educational events.
I urge you to utilize CHA’s resources and to stay informed about the progress being made by the local workgroup.
Hospitals are committed to meeting the mandates in AB 40. We understand the importance of doing better. It will take all of us working together to find solutions to the many issues contributing to delays.