Emergency department diversions: hospital and community strategies alleviate the crisis.

A nationwide surge in emergency department ambulance diversions in 2000-01 raised concerns about access and quality of care for critically ill patients, but the diversion problem has improved markedly over the past two years, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. Hospital efforts to improve bed management and patient flow, as well as community initiatives to monitor and control diversions, have played key roles in easing the problem. The success in bringing the diversion crisis under control offers an important lesson for policy makers--much can be done to better manage existing hospital capacity before potentially costly expansions are made.