Patients’ hospital preferences ignored as ERs divert ambulances

Special Reports

Pre-pandemic, emergency officials for the region would enact zone management two or three times a week. Now, it’s a daily occurrence.

PORTLAND, Ore. (KOIN) — Portland-area hospitals were already pretty full before the pandemic began. Now, with COVID-19 patients, emergency rooms are filling up faster, causing hospitals to go on divert, which means ambulance patients might not get taken to the hospital of their choice. 

Typically, when a patient needs to be transported by ambulance, they have the right to choose which facility they go to, as long as it’s a rational request. A paramedic will deny their request if the patient has a traumatic injury that requires treatment at a specific hospital or if the paramedic fears for the patient’s life and feels they need to go immediately to the nearest emergency room. 

The Portland metro area is divided into several zones. When all the hospitals in a zone are on divert, meaning they can’t treat additional patients promptly, they go into what’s called zone management. 

When this happens, dispatchers begin cycling through hospitals in a zone, directing paramedics on where to bring their patients.

Pre-pandemic, emergency officials for the region would enact zone management two or three times a week. Now, it’s a daily occurrence. 

For patients, this limits where an ambulance can take them. 

“It might not be exactly the one you were hoping for, but we’re going to, we’re working together, you know, the system is really showing that we’re working together to make sure that we’re getting patients to the care that they need when they need it, even when things are tight across the city,” said Coral Barreto-Costa, mission control operations manager at Oregon Health & Science University. 

Barreto-Costa said Portland hospitals aren’t packed full of COVID-19 patients. She said a lot of the space is occupied by people who come in for routine things like surgeries and delivering babies. During the pandemic, hospitals haven’t been using as many shared rooms and nursing homes are being selective on what patients they’re admitting, which leaves more people and less available space inside facilities. 

She said it’s a chain reaction. When rooms are full, people can’t move out of the emergency room quickly, and there’s not enough room to admit new patients. 

During zone management, paramedics are working to keep patients as close to their homes as possible and that might mean they don’t go to the hospital they’d prefer. 

Barreto-Costa said if patients really want to go to a specific hospital, they can discuss it with their paramedic, but the paramedic will ultimately make the decision that’s best for the patient’s health. 

Barreto-Costa stressed that even though hospitals are busy, people should still not hesitate to call 911 for emergency transport.

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