Recent evidence demonstrates that emergency department (ED) and inpatient hospital crowding contributes to unsafe patient care. The blizzards of 2010 produced conditions that prohibited the safe discharge of admitted inpatients and were identified as a major factor in crowding of the ED at Howard County General Hospital (HCGH). At one point, admitted patients occupied 35 of the 36 treatment beds in the ED. A novel intervention was conceived and created that used the resources of Howard County Fire and Rescue (HCFR) to transport discharged patients from the inpatient floors to their home, thereby decreasing ED boarding and crowding. Throughout the 12-hour operation, HCFR personnel transported 13 patients from hospital inpatient floors to their home, and two ED interfacility transports were performed. In addition, HCFR units conducted one rescue and successful resuscitation of a patient with a sudden cardiac arrest during a 911 emergency call. During this call, HCFR and HCGH also coordinated the emergency transport of an interventional cardiologist through the blizzard to HCGH to perform emergency cardiac catheterization. At the end of the operational period, the ED had regained all but four beds pending inpatient admission. These efforts fortified a strong partnership between a community hospital and local fire department to facilitate the expeditious discharge and disposition of inpatients during the blizzards of 2010 to decrease crowding.
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