Texas hospital officials explain EMS diversion due to population boom

“The reason for the diversion was that we were understaffed to safely manage the number of patients in the hospital"


Stewart Doreen
Midland Reporter-Telegram, Texas

MIDLAND, Texas — Increased population from the oil boom forced an unusual diversion of emergency medical services meant for Midland Memorial Hospital to Odessa, according to Hospital’s vice president of Medical Affairs for Midland Health.

Dr. Lawrence A. Wilson told the Reporter-Telegram that the hospital went on diversion twice this past weekend. The first -- Friday night into Saturday, he said -- forced just out-of-county EMS to be diverted to Medical Center Hospital in Odessa. The second – from after midnight Sunday to around 9 a.m. Monday – forced all EMS, including those inside Midland County to be diverted to Odessa.

Wilson called the situations this weekend a “reality of the circumstance of volume we are seeing” and that diversions occur from time to time at hospitals around the region.

Wilson had written medical officials to update them on the need for diversions. He said the intent of the letter was not to alarm the medical community but to create awareness about the processes followed during diversion.

In the letter, Wilson stated, “The reason for the diversion was that we were understaffed to safely manage the number of patients in the hospital.” He added in the letter – and the repeated to the Reporter-Telegram -- that normally by this time of year, the hospital’s inpatient census has decreased. He said hospital officials forecasted a reduction of patients and “being cognizant of the hospital’s financial situation we eliminated the costly contract labor that had helped cover the winter months.”

“It appears the Midland boom has begun to influence our patient flow,” Wilson wrote. “We are having further conversations about staffing needs, but if trends continue we will need to contract for more nursing support. … If volume trends persist, we may have further days in the next month or two when we will need to go on diversion.”

His observations about the diverting process included:

--the need for proper communication, including EMS and surrounding facilities;

--recognizing patients who would be best served by coming to Midland Memorial Hospital regardless of divert status;

--the handling of “drive-up” complex patients.

“Any patient that arrives to our ER will need to be stabilized and then a decision made about need to transfer or not.”

***

The letter, sent out from Dr. Lawrence A. Wilson, follows in its entirety.

Medical Staff:

Over the weekend Midland Memorial was forced to go on divert on two occasions. For a block of time Friday night into Saturday, and again after midnight last night until about 9:00 this morning we diverted EMS from in and out of county. The reason for the diversion was that we were understaffed to safely manage the number of patients in the hospital.

Normally by this time of year our inpatient census has decreased. We had forecasted for a reduction of patients and being cognizant of the hospital’s financial situation we eliminated the costly contract labor that had helped cover the winter months.

It appears the Midland boom has begun to influence our patient flow. We are having further conversations about staffing needs, but if trends continue we will need to contract for more nursing support. It will take several weeks to ramp up to the need. If volume trends persist we may have further days in the next month or two when we will need to go on diversion.

A few observations from this weekend:

Communication about diversion: Once the decision to go on divert is made the medical staff, particularly those on call, need to be notified. EMS, the RAC and surrounding facilities need to be notified.

Recognizing patients that would best be served by coming to us regardless of divert status- i.e. if a patient had recently been operated upon by one of our surgeons, that surgeon should be part of the decision to divert or not.

How to handle drive up complex patients. Any patient that arrives to our ER will need to be stabilized and then a decision made about need to transfer or not.

I am sure that some of you have questions or suggestions. We are committed to do the best we can to keep the quality of care for our community the best possible. To accomplish that, keeping you informed is paramount.

Thank you for your understanding.

Lawrence A. Wilson, MD, MBA, FACEP

Vice President Medical Affairs/CMO

Midland Health

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©2019 the Midland Reporter-Telegram (Midland, Texas)

Distributed by Tribune Content Agency, LLC.

McClatchy-Tribune News Service

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