Tyler hospitals use divert protocols to help manage high patient loads

AN AMBULANCE PASSES BY East Texas Medical Center in Tyler. A divert status at a hospital has no effect on patients who do not arrive by ambulance; walk-in patients are accepted at all times, hospital officials said.

People who need emergency medical care should not be concerned that Tyler hospitals have at times enacted a cooperative divert plan, hospital representatives said.

The plan has been used recently because Tyler's largest hospitals are seeing a large number of patients with flu-like symptoms.

"During times of increased volume, such as the current increase in local flu cases, the hospital emergency department's policy may indicate the need to go onto temporary divert status," said Jason Proctor, chief operating officer of Christus Mother Frances Hospitals.

"Going onto divert status is an extremely common tactic used by hospitals across the country to ensure the highest quality of care for patients in the emergency care center by working together with other area facilities to manage the flow of patients," Proctor said.

When a hospital enacts divert status, patients being transported by ground or air ambulance are directed to another facility, said Dr. Robert Creath, chief of emergency services at East Texas Medical Center.

The plan helps ensure that patients arriving by ambulance end up at the hospital best able to handle more patients, he said.

A divert status has no effect on patients who do not arrive by ambulance. Hospitals in Tyler accept walk-in patients to their emergency rooms at all times, the hospital representatives said.

Divert status "has no bearing on other patients coming into the hospital or emergency room" and "absolutely should not discourage any patient from seeking the treatment they need at the facility of their choosing," Proctor said.

Creath said he is not aware of any patient having to be diverted by ambulance to a hospital outside of Tyler.

According to American College of Emergency Physicians guidelines, hospitals and EMS agencies must have working divert agreements.

"Ambulance diversion should occur only after the hospital has exhausted all internal mechanisms to avert a diversion, which includes calling in overtime staff," according to the guidelines. "The decision for diversion should be made by the emergency physician in the emergency department in coordination with nursing and/or administrative staff."

The guidelines state that diversion must be temporary and that the medical provider must return to normal operation as quickly as possible.

Hundreds of patients who are suffering from flu-like symptoms are being treated at Tyler hospitals, said representatives from ETMC and Christus Mother Frances hospitals.

In the past week ETMC has treated 236 patients with flulike symptoms and Christus Mother Frances Hospital-Tyler has treated 85, representatives of the hospitals said on Wednesday.

Rebecca Berkley, ETMC's director of public relations, said the hospital at time has been near capacity and that wait times in the emergency room are currently longer than usual.

Representatives from ETMC and Christus said they have taken steps to deal with increased patient loads and emergency room traffic.

"We prepare for increased volumes in the way we operate the ER each day," Proctor said. "The standard processes that are in place to assess, diagnose and treat patients in our Emergency Care Center are centered around evidence-based best practices for emergency care."

Jennifer Cole, director of infection control at Christus, said that most people with mild flulike symptoms should also consider seeking care from their primary care doctor or an urgent care center.

Those with flu-like symptoms who are very old or very young, have other health concerns or are having high fever, dizziness, confusion, vomiting or flu-like symptoms that went away and then returned with a fever and cough should seek care at an emergency room.

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