Building a unified communications centre to improve the distribution of EMS patients to a large multi-hospital health system

In 2023, hospital care-based models are faced with increasing patient volumes, limited physical space and limited resources. These constraints, felt in almost all acute-based care models, is leading to a crucial crossroads in acute care delivery. Balancing capacity and availability of hospital and system resources is almost impossible in this environment, as need greatly exceeds access to resources and patient care delivery can be significantly hindered. Historically, emergency medical services (EMS) brought patients to the nearest available emergency department (ED), and load balancing could only be accomplished after arrival in the ED. Intervening earlier in patient’s care by providing EMS with destination recommendations based on available resources optimises patient outcomes and decreases the burden on any individual hospital. This change can also greatly affect EMS processes to improve transport times and decrease wall time, the time that EMS crews spend at the hospital waiting to offload their patients into a hospital bed. Wall times can exceed several hours depending on location, time of day and patient resource needs. Reduction of this waiting time has the potential to profoundly improve throughput and patient-centred metrics like patient satisfaction, length of stay and admission rates, as well as reduce overall risk. This also allows health systems to maintain community resources by decreasing EMS crews’ idle time at the hospital. Through the creation of a unified communication centre (UCC), we sought to create a structure that appropriately stratified patients to the most appropriate system hospitals while still in the care of EMS. Our team’s goal was to optimise patient treatment, decrease wall time with EMS, and route patients to the most appropriate facility based on the patient’s medical complaints, hospital capacity and hospital capability in the community.