UTSW/BioTel Policy: EMS Unit Wait Times at Receiving Hospitals

Purpose: The purpose of this policy is to minimize “Wait Times” for EMS units at receiving hospitals.

BACKGROUND:

Due to emergency department (ED) overcrowding and staffing issues, ambulances are occasionally asked to wait prior to transferring their patient to the care of ED staff.
This policy is intended to offer guidance to UTSW/BioTel paramedics who, upon arrival with a patient at an ED, are asked to wait prior to the transfer of the care of their patient to ED staff.

GUIDELINES:

All UTSW/BioTel paramedics shall comply with the following guidelines:

  1. When a member of a hospital ED staff indicates that the wait time for the transfer of care will exceed twenty (20) minutes, then the paramedic crew will ask to speak with the ED Charge Nurse.  They shall ask the Charge Nurse to verify that the paramedics and EMS unit will be out of service at the hospital for at least 20 minutes while waiting for the ED staff to assume full responsibility for the patient.  They shall then communicate to the Charge Nurse that UTSW/BioTel procedures do not allow for ambulances to remain at a hospital for an extended time, and shall ask that the patient transfer be expedited as soon as possible.
  2. If the ED staff indicates that the wait time will exceed thirty (30) minutes, or if the actual waiting time passes thirty (30) minutes, then the paramedics shall contact the appropriate Field Supervisor.  The Field Supervisor shall contact the on-duty Charge Nurse of the ED via telephone to request that the ED staff immediately accept full responsibility for the patient in order to free up the paramedics and EMS unit.  If the Charge Nurse indicates that the ED cannot comply with this request, then the Field Supervisor will respond to that Emergency Department, Code-1, and will request that the hospital’s “Administrator On Call” be paged. While en-route to the hospital, the Field Supervisor shall contact BioTel and ask that the EMS Medical Director, or his designee, be notified of the situation.
  3. Paramedics are reminded that once they have arrived on hospital property, they MUST deliver their patient to ED staff, and that they may ONLY leave that hospital with their patient following direction of a BioTel Medical Command Physician. To do otherwise would constitute an EMTALA violation (Refer to the EMTALA Policy).
  4. UTSW/BioTel paramedics will act professionally when dealing with ED staff at all times and shall defer to their Field Supervisor or the BioTel EMS Medical Director to resolve these issues, if need be.