Time spent by EMS at hospital
Time from when an ambulance first arrives with a patient at a hospital to when that ambulance and its crew are available to respond to another call. (see data dictionary)
What do you see?
- Are there any trends over time at the emergency department(s) where you work or would be most likely to visit?
- Looking at hospitals of the same type (e.g., Large Urban), are there differences in the times EMS spends at the hospital?
- Could the number of patients who visited each emergency department be a reason for the differences that you see between sites?
Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.
* Alberta Health Services, Emergency Medical Services, System Performance and Innovation. “EMS Computer Assisted Dispatch (CAD) data.” (2020) [Data showing median and 90th percentile results for the length of time between when the ambulance first arrives at a hospital with a patient and when that ambulance and its crew are once again available to respond to another call, by facility, month, and quarter].
Understanding “time spent by EMS at hospital”
When patients are brought to the hospital by ambulance, the work of EMS staff is not complete. Once at the hospital, EMS teams continue providing care to their patients until they are formally transferred to the care of emergency department staff.
The chart above tells us how long EMS staff spend at the hospital, from when the ambulance first arrives with a patient, to when that ambulance and its crew are once again available to respond to another call. While at the hospital, EMS staff remain with their patient, assessing and providing treatments. This continues until the patient is transferred from EMS care to an available emergency department bed, or until the patient is moved to a waiting area – if determined that EMS is no longer required to care for the patient while waiting.
Once the EMS patient has been transferred to an emergency department bed, the EMS crew is still unable to respond to a new call until they have restocked their ambulance. This is an important step, as it ensures EMS staff will have the supplies they need for their next patient.
What impacts this time frame?
The time spent by EMS at hospital before they can respond to another call can be affected by many different factors. These include the volume and urgency of other patients waiting in the emergency department, and the efficiency of the emergency department. One example of efficiency in the emergency department is the time it takes to get a specialist/admitting doctor opinion. Another factor which can impact this time frame is how many hospital beds are occupied, since EMS time spent at the hospital can be lengthened when the emergency department is full because other patients are waiting there for a hospital bed to become available.
What is the target?
Alberta Health Services has set a target that 9 out of every 10 ambulances spend less than 90 minutes at the hospital. When this target is met, EMS crews would be available to respond to another call within 90 minutes of arriving at a hospital with a patient. For more information about this target, please click here.
When there are differences in the time spent at the hospital by EMS at different emergency departments of the same size, or in the same emergency department over many months, it is a flag to ask why. If EMS time spent at the hospital is getting longer, this information can be used to start a conversation between patients, EMS staff, hospital staff, and healthcare leadership about possible causes and opportunities for improvement.
Results prior to January 2018 are excluded for the Chinook Regional Hospital (Lethbridge) because data was not available prior to this time.
The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess the emergency department’s performance in these dimensions of quality:
Dimensions of Quality