CEO Messages

No Quick or Easy Solution for Offload Delays

It’s a years-long problem with a long name: ambulance patient offload delays (APOD). This long-standing issue is wreaking havoc on the health care system, not just in our region but throughout the state and the country. And while there may not be a quick and easy solution, CHA and Hospital Council are actively engaging on this important issue with the state’s Emergency Medical Services Agency as well as local officials.

On the statewide level, the newly created APOD Task Force is meeting regularly with stakeholders to develop a comprehensive list of recommendations for the public health and medical system, including EMS, to reduce and eliminate APOD and life-threatening ambulance patient offload times statewide. This group is focused on systemic long-term solutions rather than on the short term, and we continue to emphasize that current data collection efforts need to be strengthened in order to improve the delays.

 Last week, CHA had a chance to reinforce the need for proper data collection during the Assembly Emergency Management Committee informational hearing on the issue. It consisted of two panels: the first provided an operational perspective and potential solutions, while the second (on which CHA testified) provided information on current local and statewide efforts to reduce ambulance patient offload delays/wall times.

CHA’s testimony included detailing the problem (health system capacity issues that contribute to overcrowding), current and past efforts to alleviate APOD, and what’s needed. CHA believes the current system of APOD tracking is rudimentary and only describes time increments. To address these delays, it was noted in the Assembly testimony that we need:

  • Objective and reliable real-time data that are consistent, accurate, and properly adjusted for material considerations (such as volume and clinical severity)
  • Data to help identify gaps in community services, which often contribute to patients seeking care in an ED

It’s important to note that while this remains a statewide problem, it’s an issue that is best addressed at the local level. For instance, in Sacramento County hospitals are urging EMS crews to begin using the assess and refer policy that was implemented in November 2021 to help decompress ED volumes (see details below in Section Update) during this pandemic.

 While this hearing was informational, it’s possible that legislation will be introduced in an attempt to address this issue in the short term. CHA and Hospital Council will continue to proactively engage, advocate, and update members on where things stand. As always, feel free to reach out to any of us with questions or concerns.