When Central Ohio hospitals reach capacity with an influx of patients in their ERs, they’re allowed to divert ambulances to other nearby hospitals. And when enough hospitals go on diversion, the city goes on what’s called an Emergency Patient Transport Plan, or EPTP.
The number of hours Columbus spent on that status has exploded this summer, especially compared to previous years.
How The Emergency Patient Transport Plan Works
In general, EPTPs and diversions are not required by law, and those involved with it are merely in agreement of how it works. This means the fire department, medics and the hospitals.
Columbus Division of Fire battalion chief Steve Martin said when there are no more rooms for patients in the emergency department, hospitals might have to start treating patients in the waiting rooms or even hallways. So, they can put themselves on divert for ambulance-transported patients, which Martin said helps them ease patient intake.
"The last thing they need is for ambulances to continue bringing patients in. They need to process what’s in the emergency department first," Martin said. "So it doesn’t mean that the emergency department is closed, but they will go on, they will say, ‘Hey, please, we’re going to go on diversion.’”
Columbus Fire will then share that information with other department dispatchers and will send ambulances to the next closest hospital.
But if three or more hospitals reach this status, they go into the Central Ohio Trauma System’s Emergency Patient Transport Plan, or EPTP.
Martin said when the city goes on EPTP, the fire department has an additional dispatcher that will run a channel solely for organizing transports of people who have called 911, and the fire department has responded to the emergency. The medics from that run will then call the dispatcher for further instructions.
“And that dispatcher is basically like a card dealer. And he’s going to [say], ‘You’re going to this hospital, you’re going to the next one, you’re going to go to the next one,'" he said. "Smaller hospitals might get one patient on every turn whereas the larger hospitals may take two, and that’s been pre-agreed to.”
A Summer Of Citywide Diversions
The Central Ohio Trauma System tracks how often EPTPs have been issued. And in the months of June and July this year, they saw a huge spike in hours EPTPs have been active compared to the last six years.
In June, they estimated over 110 hours of EPTP, and in July that number exceeded 130 hours. The only time an EPTP has been activated in those months in the last six years was June 2019 with just under 30 hours. The only month that has ever gotten close to these numbers was in January 2017, which also had an EPTP lasting over 110 hours.
Sherri Kovach is the president of the Central Ohio Trauma System and said it’s hard to pinpoint one reason for this major spike.
She said in any given year in the last 20 years that the plan’s been active, there might be three to nine EPTP activations. But she sid there have been at least 24 in the past four months alone.
Kovach pointed to one theory for the spike, which is more people needing emergency care after putting it off earlier in the pandemic out of fear of exposure to COVID. And with states being open for a while again, she said E.R.s have been seeing an increase of care that are unrelated to the coronavirus.
“And then in addition to this Delta spike that we’re seeing over the last several months, so add that all together, and our EDs are unusually busy at this time," she said. "And if you look across the United States, that seems to be a common theme.”
Kovach added that almost every year in September, there are random spikes in EPTP activation hours, which she said nobody can really figure out why. And with COVID numbers rising again, she believes that number could spike even higher this year.
