On Sept. 1, hospitals must submit an ambulance patient offload time (APOT) reduction protocol under Assembly Bill 40. This bill requires hospitals to include mechanisms that will improve internal operations and reduce APOT. The standard is 30 minutes, 90% of the time for general acute care hospitals with emergency departments.
While everyone agrees patients should be transferred quickly, thousands of patients remain hospitalized every day due to discharge challenges such as limited post-acute care capacity and insurance company delays and denials. APOT is a complex issue, resulting from systemic challenges across the entire health care delivery system. A few of our updates on APOT include:
- In our East Bay Section, Alameda County emergency medical services (EMS) is preparing to submit a response to the Alameda County Civil Grand Jury’s report by the Sept. 24 deadline. The report was released with a section on APOT called “Hurry Up and Wait: Ambulance Service Delayed by Long Turn-Around Times at ERs.” While the report blames hospitals for APOT, Alameda County EMS has also raised concerns about report flaws and notes some of the jury’s recommendations are already underway.
- As mentioned previously, the Sacramento County Emergency Medical Services Agency convened 18 hospital and fire department leaders on June 26 to tackle a systemic APOT improvement process. Meetings will occur every four weeks until the Sept. 1 deadline and potentially beyond.
- Hospital Council will continue engaging directly with California’s Emergency Medical Services Authority at our board meetings to discuss APOT. This issue does not begin or end with the hospital — it is a community issue.
To help address APOT, the California Hospital Association (CHA) recently released the following materials for CHA members as hospitals work to develop their APOT reduction protocol and incorporate it into organizational strategy. While these resources are valuable, it will take all of us working together to find solutions to the many issues contributing to delays.