Endorsed Resources

PACEP EMS DTP Committee Diversion Policy

Diversion of arriving ambulances from overburdened hospital emergency departments has been used in Pennsylvania as a mechanism for dealing with ED overcrowding during times of high patient census, or temporary unavailability of specific services. This has been an increasing issue facing EMS providers in Pennsylvania given the increase in patient volumes, acuity, and subsequent increased stress on healthcare given the recent COVID-19 pandemic in the face of increased volume and acuity of patients as well as hospital staffing shortages. Preceding the pandemic, there was a patchwork of differing regional policies and practices regarding EMS diversion without uniformity between EMS regions, counties, or municipalities.

PACEP last reviewed this topic in depth in 2004 with PEHSC, producing an authoritative document. However, much has changed in the interim. The EMS Disaster and Terrorism Preparedness Committee (EMS DTP) of PACEP wishes to review this issue to serve patients, EMS providers, and emergency physicians to clarify current practice and policy regarding ambulance diversion in order that EMS can deliver patients to an emergency department that has the capacity (within regional availability of resources) to provide the necessary services for their care, with the least amount of EMS system impact, aligned with PA DOH BLS and ALS protocols. We have asked all of the EMS regions of Pennsylvania to provide us with formal or informal policy regarding diversion.

This document will include definition of common terms, discuss formal diversion policy, the use of internet- based applications of emergency department status, review the substance of informal correspondence with regional EMS directors, and derive conclusions regarding diversion. We will attach an addendum of available regional formal diversion policy statements as reference.

Appendix to PACEP EMS DTP Committee Diversion Policy

Warm Handoff

A warm handoff protocol, developed in partnership by the Pennsylvania departments of Health and Drug and Alcohol Programs as well and the Pennsylvania College of Emergency Physicians, and has been distributed statewide for recommended use by emergency room physicians and other healthcare professionals caring for overdose patients.

View the Pathway

Short Summary in Response to House Resolution 2016 of 2019 - Warm Hand-off's in Pennsylvania

ED Opioid Prescribing Guidelines
A task force of various state agencies, representatives from medical associations including PACEP and PAMED, provider advocates and community members developed and adopted guidelines for ten medical specialties on the safe and effective use of opioids in the treatment of pain.

Prescribing Guidelines

SAVES
PA Department of Health inspectors have been asking about the care provided to sexual assault victims and citing hospitals as noncompliant with the SAVES (Sexual Assault Victims Emergency Services) Act and/or EMTALA when patients are transferred. Both the American College of Physicians (ACEP) and the US Department of Justice (US-DOJ) support a more nuanced approach to these patients.

PACEP worked with the Hospital & Healthsystem Association of Pennsylvania (HAP), the Pennsylvania Coalition Against Rape (PCAR), and the PA Chapter of the International Association of Forensic Nurses to draft a position paper.

PACEP/PEHSC Interfacility Resource Document
The PACEP EMS & Terrorism and Disaster Preparedness (EMS) Committee, in partnership with the Pennsylvania Emergency Health Services Council (PEHSC), developed the Interfacility Resource Document as a reference tool to assist referring and receiving physicians and other hospital staff with determining which type of transport is best suited to an individual patient's need.

PACEP/PEHSC Interfacility Resource Document

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