countywide emergency department 9-1-1 ambulance patient ... · overcrowding, and may be useful in...

Countywide Emergency Department 9-1-1 Ambulance

Patient Transfer of Care Report Performance Report

P r e p a r e d b y :

C o n t r a C o s t a E m e r g e n c y M e d i c a l S e r v i c e s

V i s i t u s a t w w w . c c c e m s . o r g

7 / 1 5 / 2 0 1 5

Contra Costa Emergency Medical Services (EMS) System Performance Expectation EMS Policy #40: Hospitals designated as an EMS receiving facility in Contra Costa County shall be prepared to receive patients transported by 9-1-1 county ambulance providers and accept these patients upon arrival. The patient transfer of care performance expectation for the EMS System is 20 minute or less; 90% of the time.

Countywide Hospital Performance (June 2014 to May 2015)

90th Percentile of All Facilities1 Patient Transfer of Care occurs between 18 to 26 minutes 9 out of 10 times

Description of Patient Transfer of Care (TOC)

EMS patient transfer of care is known to improve the availability of 9-1-1 ambulances and patient safety. The California Hospital Association and the EMS Administrators of California have proposed the following graphic to describe the intervals associated with patient transfer of care. In Contra Costa County our metric of patient transfer of care or handoff time is equivalent to the ambulance patient offload time interval.

1 San Ramon Regional Medical Center is not included in the all facilities reporting. San Ramon Regional Medical Center is served primarily by San Ramon Fire Protection District who does not collect this information.

Hospital Capacity and EMS Transfer of Care (TOC)

Emergency departments (ED’s) have different capacities and utilization. During 2014 Contra Costa County Community Hospitals received 11-19 percent of their patients via EMS with vast majority of all emergency department patients transporting themselves to a local emergency department for primarily urgent and sometimes routine medical care. In 2014 there were 2,379 less EMS transports to Contra Costa Hospitals. Typically 10 % of ALL emergency department patients require admission while patients brought in by EMS admission rates can be as high as 40% due to their medical condition. During 2014 overall emergency department admission rates (walk in and EMS combined) averaged between 13 to 14% in Contra Costa. Although ED crowding is a statewide and national problem patients transported by EMS are not the cause.

2 The American College of Emergency Physicians (ACEP) recommended standard is one emergency department treatment station (bed) for 2000 visits 3 This data includes all Contra Costa emergency ambulance transport data for San Ramon Fire and Moraga Orinda Fire Departments and AMR. 4 Includes Contra Costa Regional Psychiatric Emergency Patient Volume 5 Doctors Medical Center Closed to EMS Traffic on August 7, 2014 and the Hospital Closed on April21, 2015. 6 EMS Transport totals do not include transports to out of county hospitals. 28% of West County EMS transports go to Hospitals outside Contra Costa County.

County Wide Emergency Department Capacity and Utilization

ED BEDS

OSHPD TOTAL REPORTED ED

VISITS 2014

OSHPD ED VOLUME PER ED BED 20142

TOTAL EMS TRANSPORTS 2014 (All Contra Costa

County Transports)3

PERCENT OF EMS

TRANSPORTS BY TOTAL ED VISITS 2014

DAILY AVERAGE 2014 (All Contra

Costa EMS Transports)

Contra Costa Regional Medical Center4 20 56,920 2846 10,538 19% 29 Doctors Medical Center 5 25 35,717 1429 4,224 12% 12 John Muir-CONCORD 32 52,747 1648 9,345 18% 26 John Muir-WALNUT CREEK 47 45,406 966 8,008 18% 22 KAISER ANTIOCH 34 45,922 1351 5,259 11% 14 KAISER RICHMOND 15 50,303 3354 6,289 13% 17 KAISER WALNUT CREEK 52 55,128 1060 6,907 13% 19 SAN RAMON REGIONAL 12 17,230 1436 2,021 12% 6 SUTTER DELTA 32 48,630 1520 8,433 17% 23 TOTAL 6 269 408,003 1517 61,024 15% 167

The Contra Costa EMS System TOC Safety Initiative: Data Sharing for Improvement

Contra Costa Emergency Medical Services (EMS) recognizes the challenges that many hospital emergency departments face managing the increase in patient volume associated with many citizens using the Emergency Department (ED) for primary and urgent care. However, delays in the timely transfer of care of patients7, brought by 9-1-1 emergency ambulance, are known to increase risk to the patient and adversely impact the availability of providing emergency ambulance services throughout the county. It is important that all hospitals receiving emergency ambulances recognize the following:

• Approximately 10% of all 9-1-1 patients in Contra Costa experience some level of transfer of care delays when they arrive at the hospital. • Delays of greater than one hour are considered “Never Events” within the Contra Costa EMS system because they are “preventable”. • In 2014 “Never Events” affected some 401 patients of all ages at a rate of 5.24 times for every 100 patients. • When delays of more than 30 minutes occur, efforts by ED staff closest to the patient need to occur to prevent further delays in patient care. • When two or more emergency ambulances experience delays greater than 30 minutes (known as stacking) a community’s 9-1-1 ambulance

response may be adversely affected. • Emergency ambulance providers have strict response time performance requirements resulting in stiff financial penalties when delays in

response occur. • Hospitals with inpatient workflow practices that support emergency department throughput consistently demonstrate shorter patient

transfer of care times and experience significantly fewer excessive delays (never events) regardless of spikes in normal day to day emergency department volume.

To effectively collaborate and manage the patient safety issues associated with patient handoff delays, transfer of care standards and performance metrics were established for the Contra Costa EMS System. The EMS policy # 40 “EMS Prehospital-Emergency Department Transfer of Care Standards” is available at http://cchealth.org/ems/pdf/policy40.pdf. Contra Costa EMS encourages all of our EMS System partners to use this information to create effective strategies to support timely patient handoff.

The Institute of Medicine, National Quality Forum, Centers for Medicare & Medicaid Services, National Association of EMS Physicians and the California Hospital Association/Emergency Medical Services Authority Ambulance Patient Offload Delay Collaborative all recommend establishing benchmarks, metrics and engaging in data sharing to support patient safety between EMS System stakeholders.

7 Delays in timely transfer of care are also known as “offload” or patient “handoff” delays.

http://cchealth.org/ems/pdf/policy40.pdf

The County EMS System standards for patient handoff between Emergency Department (ED) and 9-1-1 ambulance personnel for all Contra Costa Community Hospitals include:

• Conducting 9-1-1 transported patient handoff as soon as possible upon ambulance arrival; • Activating appropriate measures to effectively manage ED saturation • Reducing 9-1-1 ambulance stacking during peak conditions. • Treating handoff delays of 60 minutes or more as “Never Events”. • Practicing optimal patient handoff times of 20 minutes or less

The Contra Costa EMS System patient handoff standards were established after 4 years of EMS System stakeholder participation. Beginning in January 1st, 2015, EMS began to post public reports at www.cccems.org website at appropriate intervals. We would like to thank all of our Contra Costa community hospitals for making this a high priority in their organizations. Questions about this report should be directed to Contra Costa EMS by visiting us at www.cccems.org or calling 925 646-4690.

The Metrics

Transfer of care time interval: Time from ambulance arrival on hospital premises to documented transfer of care. Transfer of care is defined as the patient being physically off the gurney and EMS personnel having completed an appropriate verbal report to hospital staff (where EMS crew has no further direct patient care duties). Any activity performed after the patient care transfer occurs is not included, e.g. clean up of ambulance and completion of prehospital patient care record.

Data elements used in reporting: Arrival of ambulance time is defined as the time the ambulance reaches hospital property and captured as an automated data point using a link to the ambulance CAD (Computer Aided Dispatch). Transfer of care time is the time that the EMS provider documents as the point in time where the patient is both physically off the gurney and the ED staff have received a verbal patient report. Fractile Performance: Measurement of percentage of time interval associated with completed transfer of care (e.g. 90% of patients with transfer of care within 20 minutes).

Average patient handoff time (min): The average time in minutes it takes to handoff patients at an individual facility or group of facilities.

http://www.cccems.org/

http://www.cccems.org/

Total number of patients: The total count of patients transported to the individual facility or group of facilities during the data collection interval.

90% Percentile (min): The amount of time (in minutes) associated with patient transfer of care for 9 out of 10 patients for a facility or group of facilities.

“Never Events” by Facility: The total count of EMS patient care transfers (handoffs) taking 60 minutes or longer. This information is displayed by year and year to date.

Demographic Patient Data associated with “Never Events”: These charts and tables capture descriptive information about patients who experience “Never Events” and includes the paramedic’s primary impression, patient’s age, sex, and ethnicity.

The Standards and Benchmarks

The following are the standards and benchmarks for the Contra Costa County EMS System in support of prompt ambulance and emergency department patient transfer of care:

• Optimal patient care transfer of care (handoff or drop time) time: 15 minutes 90% of the time • Delayed patient care transfer of care (handoff or drop time) time: 30 minutes or more • A “Never Event” for patient care transfer (handoff): 60 minutes or more

Management of Delays in Patient Transfer of Care

Contra Costa EMS works with emergency ambulance, hospital and emergency department leadership to assure prompt patient transfer of care in the emergency department. Prompt transfer of patient care enables timely definitive care and the return of 9-1-1 emergency ambulance assets to availability for the next emergency call. The Contra Costa EMS Agency provides routine reports on patient handoff to hospitals, ambulance providers, the Contra Costa Emergency Medical Care Committee and the County Board of Supervisors. Contra Costa EMS encourages hospitals to measure overcrowding as part of internal quality and patient safety efforts to improve ED/Hospital throughput. Two resources that have demonstrated value in this area include the use of the California Emergency Department Overcrowding

Scale (CEDOCS) or the National Emergency Department Overcrowding Scale (NEDOCS). Both scales provide an objective assessment of ED overcrowding, and may be useful in helping hospitals to reduce ambulance offload delays. These tools incorporate measurement of patient census, ED bed count, ED admits, in-patient bed counts, door-to-bed time in the ED, longest wait for admission and number of patients receiving 1:1 care in the ED. The score provides a measure of overcrowding that can be used to provide an early warning to hospital personnel when overcrowding is worsening. Many hospitals have developed internal response plans to address patient flow based on these overcrowding scores. By managing flow issues early, crowding can be addressed and ambulance offload delays can be minimized or eliminated.

Report Limitations This report is based on computerized dispatch and electronic patient care records for 9-1-1 ambulance data from American Medical Response (AMR). AMR provides approximately 90 % of all emergency ambulance transports within the County. The report does not include patient handoff data from Fire ambulance providers, non-emergency ambulance providers or out of county emergency ambulance providers.

Data for patient transfer of care reporting is not available from San Ramon Fire and Moraga Orinda Fire Transport Providers. Transports from these providers may significantly add to the emergency ambulance volume as they provide up to 10% of the emergency ambulance services in the county. In particular San Ramon Regional Medical Center is served almost exclusively by the San Ramon Fire Department is not included in this report while Kaiser Walnut Creek, John Muir Walnut Creek and Contra Costa Regional Center would be most affected by additional transports provided by fire ambulance providers. As fire department ambulance transfer of care data becomes available in the future it will be included in this report.

Doctor’s Medical Center closed to emergency ambulance traffic on August 7, 2014. Data collection on ambulance transfer of care stopped on Aug 7, 2014. On April 21, 2015 the hospital closed all emergency department, inpatient and outpatient services.

AMR Transports in Contra Costa Resulting in Never Events (> 1 Hour Patient Handoff Time) during 2014 and 2015 YTD

EMS System Goal: Reduce or Eliminate Patient TOC Never Events Patient transfer of care delays of 60 minutes or more are considered “never event” within the Contra Costa EMS System. This data reflects the total number of patient transfer of care of an hour or longer.

Number of Never Events by Hospital

Never Events by Facility (>1 Hour Drop

Time)

2014 Never Events

Grand Total

2014

Total Number of EMS

Transports Recevied

Never Event Rate per 100

Transports

Average Number of

Daily CCEMS

Transports

Never Events

2015 YTD (1/1/2015-5/31/2015)

CCRMC 15 6,694 0.22 18 26

CCRMC - PES 34 4,796 0.71 13 22

John Muir - Concord 19 9,345 0.20 26 2

John Muir - Walnut Creek 17 8,008 0.21 22 11

Kaiser - Antioch 10 5,259 0.19 14 10

Kaiser - Richmond 13 6,289 0.21 17 3

San Ramon8 0 2,021 0.00 6 0

Kaiser - Walnut Creek 8 6,907 0.12 19 13 Sutter Delta 285 8,433 3.38 23 1692015)

Total 401 57,752 5.24 158 256

8 Limited to AMR data, San Ramon Fire never event data not available.

Never Events Demographics

Never Events (>1 Hour Drop Time) By Patient Gender

2013 (8/1/2013 - 12/31/2013)

2014 (1/1/2014 - 12/31/2014)

2015 (1/1/2015-5/31/2015)

Grand Total

Female 32 235 144 411 Male 30 166 112 308

Never Events (>1 Hour Drop Time)

By Patient Ethnicity 2013

(8/1/2013 - 12/31/2013)

2014 (1/1/2014 - 12/31/2014)

2015 (1/1/2015-5/31/2015)

Grand Total

Asian 2 17 10 29 Black/African American 19 106 66 191 Caucasian 29 200 121 350 Hispanic or Latino 11 49 40 100 Other Race 1 29 19 49

Never Events (>1 Hour Drop Time)

By Patient Age 2013

(8/1/2013 - 12/31/2013)

2014 (1/1/2014 - 12/31/2014)

2015 (1/1/2015-5/31/2015)

Grand Total

0-9 1 9 5 15 10-19 5 21 9 35 20-29 7 41 33 81 30-39 5 37 32 74 40-49 8 58 31 97 50-59 10 65 42 117 60-69 10 70 39 119 70-79 8 41 27 76 80-89 4 42 25 71 90-100 4 16 13 33 > 100 0 1 0 1

Understanding the Clinical Characteristics of “Never Event” Patients May Assist Hospitals in Identifying At-Risk Populations

Paramedic Primary Impressions Never Events (>1 Hour Drop Time)

2013 (8/1/2013 - 12/31/2013)

2014 (1/1/2014 - 12/31/2014)

2015 (1/1/2015-5/31/2015)

Grand Total

Pain 15 96 40 151 Other - Sick/Dizzy/Weakness 11 50 22 83 Trauma 5 45 16 66 Behavioral / Psychiatric 7 51 25 83 Neurological 5 36 15 56 Respiratory 4 26 12 42 Gastrointestinal 5 24 15 44 Toxicological 3 25 14 42 Cardiac 5 17 14 36 Vascular 1 23 12 36 Diabetes 0 5 2 7 OB/GYN 0 3 1 4 Allergic Reaction 1 0 1 2

Many of these conditions may be minor; however no patient should wait more than one hour for EMS/ED transfer of care. In California, when 9-1-1 is contacted the ambulance provider is required by law to take the patient to an emergency department although up to 60% of all EMS transports are “treat and release” within 24 hours. Future EMS and Hospital partnerships could redirect patients to non 9-1-1 resources and encourage the use of alternative primary or urgent care settings more appropriate for the patient condition. Such options could play an important role in conserving EMS ambulance and Emergency Department resources for the sickest of patients.

“Never Events” Affect a Wide Range of Patient Conditions Patients with low, moderate or high acuity conditions can experience prolonged patient transfer of care events of greater than an hour. Patients with low acuity conditions may be better served by urgent care or same day appointments. Paramedic primary impressions are not verified clinical diagnoses. Paramedic primary impression categories reflect the field paramedic assessment of the patient prior to the Emergency Department.

• Trauma “Never Event” data reflect patients who do not have major trauma by paramedic impression

0:18:07 0:20:01 0:20:55 0:20:13

0:18:50 0:20:30

0:23:34 0:25:04

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0:30:00

0:35:00

0:40:00

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0:55:00

1:00:00

Jul '144,411

Aug '144,571

Sep '144,743

Oct '144,783

Nov '144,573

Dec '155,262

Jan '155,348

Feb '154,803

Mar '155,141

Apr '155,326

May '155,407

Jun '155,302

Month & AMR Transport Volume

Patient Handoff Times by Facility 90th PERCENTILE OF ALL FACILITIES

July 2014 - June 2015 59,670 Transports (4,973 per Month)

Source: AMR MEDS (ePCR Database)

KP-Richmond began to implement CCEMS West

County Directed Destination Protocol on

8/18/2014. Doctors Medical Center closed its doors at 7:00

Am on 4/21/2015

0:00:00

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0:25:00

0:30:00

0:35:00

0:40:00

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0:50:00

0:55:00

1:00:00

Jul '144,411

Aug '144,571

Sep '144,743

Oct '144,783

Nov '144,573

Dec '155,262

Jan '155,348

Feb '154,803

Mar '155,141

Apr '155,326

May '155,407

Jun '155,302


Patient Handoff Times by Facility (90th Percentile) July 2014 - June 2015


John Muir - Concord John Muir - Walnut Creek Kaiser Hospital - Antioch

Kaiser Hospital - Richmond Kaiser Hospital - Walnut Creek Contra Costa Regional Medical Center

Sutter Delta Medical Center PES - Contra Costa Regional Medical Center



8/18/2014.

Doctors Medical Center closed its doors at 7:00

Am on 4/21/2015

0:11:46 0:12:17 0:13:55 0:13:18 0:13:00 0:13:00

0:15:09 0:14:35 0:14:51 0:16:42

0:15:06 0:15:00

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0:20:00

0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14708

Aug '14695

Sep '14721

Oct '14719

Nov '14709

Dec '14822

Jan '15863

Feb '15752

Mar '15823

Apr '15770

May '15848

Jun '15835


Patient Handoff Times by Facility (90th Percentile) John Muir - Concord July 2014 - June 2015

9,265 Total Transports (772 per Month) Source: AMR MEDS (ePCR Database)

0:12:30 0:14:14 0:13:58 0:13:19 0:13:21

0:15:00 0:17:18

0:18:27 0:17:05

0:19:16 0:17:26 0:16:37

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0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14645

Aug '14600

Sep '14597

Oct '14675

Nov '14658

Dec '14764

Jan '15774

Feb '15672

Mar '15703

Apr '15742

May '15762

Jun '15714


Patient Handoff Times by Facility (90th Percentile) John Muir - Walnut Creek

July 2014 - June 2015 8,306 Total Transports (692 per Month)


0:14:26 0:15:37

0:16:59 0:16:04 0:17:58

0:19:27 0:20:25 0:21:04 0:19:00

0:20:21 0:19:56 0:20:23

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0:25:00

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0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14439

Aug '14457

Sep '14431

Oct '14450

Nov '14439

Dec '14526

Jan '15546

Feb '15495

Mar '15538

Apr '15529

May '15517

Jun '15510


Patient Handoff Times by Facility (90th Percentile) Kaiser - Antioch



0:13:33 0:15:10

0:16:37 0:15:51 0:14:45 0:15:19 0:15:32 0:17:00 0:16:00

0:17:55 0:18:56 0:20:00

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0:05:00

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0:20:00

0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14496

Aug '14695

Sep '14771

Oct '14651

Nov '14604

Dec '14648

Jan '15584

Feb '15533

Mar '15692

Apr '15822

May '15709

Jun '15759


Patient Handoff Times by Facility (90th Percentile) Kaiser - Richmond July 2014 - June 2015

7,964 Total Transports (664 per Month) Source: AMR MEDS (ePCR Database)



8/18/2014.

Doctors Medical Center closed its doors at 7:00

Am on 4/21/2015

0:14:10 0:14:37

0:17:51 0:16:00 0:15:13

0:17:46

0:22:07 0:22:29

0:25:37 0:24:49 0:23:00

0:21:00

0:00:00

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0:20:00

0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14487

Aug '14468

Sep '14487

Oct '14505

Nov '14469

Dec '14553

Jan '15604

Feb '15508

Mar '15557

Apr '15608

May '15575

Jun '15564


Patient Handoff Times by Facility (90th Percentile) Kaiser - Walnut Creek



0:17:48 0:16:22

0:20:48 0:19:27

0:17:02

0:22:27

0:26:01 0:27:07

0:22:57

0:27:58 0:27:01 0:29:31

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0:20:00

0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14337

Aug '14394

Sep '14435

Oct '14464

Nov '14444

Dec '14484

Jan '15510

Feb '15466

Mar '15438

Apr '15450

May '15487

Jun '15459


Patient Handoff Times by Facility (90th Percentile) Contra Costa Regional Medical Center



0:23:00 0:25:12

0:29:00 0:26:33 0:27:17

0:31:24 0:32:00 0:30:12

0:32:56 0:31:13

0:32:53 0:31:24

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0:20:00

0:25:00

0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14535

Aug '14544

Sep '14612

Oct '14591

Nov '14564

Dec '14679

Jan '15623

Feb '15606

Mar '15658

Apr '15612

May '15659

Jun '15653


Patient Handoff Times by Facility (90th Percentile) CCRMC - PES



0:34:00

0:50:57

0:43:05

0:37:35

0:29:59

0:33:09 0:34:06

0:41:00

0:32:33

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0:30:00

0:35:00

0:40:00

0:45:00

0:50:00

0:55:00

1:00:00

Jul '14764

Aug '14718

Sep '14689

Oct '14728

Nov '14686

Dec '14786

Jan '15844

Feb '15771

Mar '15732

Apr '15793

May '15850

Jun '15808


Patient Handoff Times by Facility (90th Percentile) Sutter Delta Medical Center



0:07

:13,

708

0:07

:18,

645

0:08

:52,

439

0:08

:20,

496

0:08

:36,

487

0:07

:39,

695

0:08

:31,

600

0:09

:07,

457

0:08

:46,

695

0:08

:42,

468

0:08

:50,

721

0:07

:58,

597

0:09

:36,

431

0:10

:02,

771

0:10

:02,

487

0:08

:03,

719

0:08

:00,

675

0:09

:02,

450

0:08

:43,

651

0:09

:26,

505

0:07

:45,

709

0:07

:57,

658

0:09

:57,

439

0:08

:04,

604

0:09

:34,

469

0:07

:45,

822

0:08

:29,

764

0:10

:02,

526

0:08

:20,

648

0:10

:18,

553

0:08

:36,

863

0:09

:57,

774

0:11

:34,

546

0:08

:29,

584

0:12

:26,

604

0:08

:32,

752

0:10

:07,

672

0:12

:09,

495

0:08

:55,

533

0:12

:42,

508

0:08

:43,

823

0:09

:38,

703

0:10

:45,

538

0:08

:53,

692

0:14

:10,

557

0:08

:56,

770

0:10

:31,

742

0:11

:31,

529

0:09

:36,

822

0:13

:40,

608

0:08

:35,

848

0:09

:32,

762

0:10

:51,

517

0:10

:09,

709

0:12

:52,

575

0:09

:05,

837

0:09

:30,

715

0:11

:35,

515

0:10

:29,

762

0:12

:20,

570

0:00:00

0:05:00

0:10:00

0:15:00

0:20:00

0:25:00

John Muir - Concord John Muir - Walnut Creek Kaiser Hospital - Antioch Kaiser Hospital - Richmond Kaiser Hospital - Walnut Creek

Average Patient Handoff Times by Facility July 2014 - June 2015 by Month

37,814 Total Transports Source: AMR MEDS (ePCR Database)



8/18/2014.

Doctors Medical Center closed its doors at 7:00 AM

on 4/21/2015

0:09

:57,

337

0:16

:06,

764

0:12

:27,

535

0:09

:29,

394

0:21

:15,

718

0:13

:13,

544

0:11

:13,

435

0:19

:11,

689

0:14

:32,

612

0:10

:15,

464

0:17

:57,

728

0:14

:17,

591

0:09

:36,

444

0:14

:44,

686

0:14

:39,

564

0:12

:07,

484

0:15

:49,

786

0:15

:50,

679

0:13

:40,

510

0:17

:01,

844

0:16

:37,

623

0:14

:20,

466

0:19

:31,

771

0:15

:57,

606

0:12

:07,

438

0:17

:18,

732

0:16

:50,

658

0:15

:14,

450

0:21

:43,

793

0:16

:45,

612

0:14

:45,

487

0:23

:16,

850

0:16

:58,

659

0:14

:54,

462

0:23

:00,

813

0:17

:17,

653

0:00:00

0:05:00

0:10:00

0:15:00

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Contra Costa Regional Medical Center * Sutter Delta Medical Center PES - Contra Costa Regional Medical Center

Average Patient Handoff Times by Facility July 2014 - June 2015 by Month

21,881 Total Transports Source: AMR MEDS (ePCR Database)

*Note: CCRMC data may include patients who were actually taken to PES. Contra Costa EMS is working to more accurately identify whether patients were taken to CCRMC ED or PES.

countywide emergency department 9-1-1 ambulance patient ... · overcrowding, and may be useful in...

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