Photo Credit: Marco_Piunti

The following is a summary of “Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard,” published in the January 2025 issue of Emergency Medicine by Baan-Kooman et al. 

In 2013, emergency department (ED) crowding was a growing global concern, with 68% of Dutch ED managers reporting frequent crowding. 

Researchers conducted a retrospective study to evaluate the phased introduction and adoption of an ambulance diversion dashboard visualizing regional diversions using a traffic light system. 

They used a nationwide online survey of Dutch EDs conducted between January and October 2023. The survey included qualitative and quantitative questions. Descriptive data were analyzed, focusing on experiences of crowding, usage, and perceived effectiveness of the ambulance diversion dashboard. 

The results showed that at the time of the survey, 62 of 82 Dutch EDs (75.6%) utilized the ambulance diversion dashboard, with responses from 56 EDs (90.3% response rate). A total of 69.7% of ED managers reported experiencing crowding more than three times weekly. Among dashboard users, 52.8% stated it only occasionally reduced ED inflow, citing limited impact due to the small number of patients redirected by the red light (ambulance diversion) and regional crowding. The effect of the orange light (impending ambulance diversion) on ED input varied significantly across hospitals, influenced by internal agreements. Additionally, 53.6% of respondents were dissatisfied with the resources available to address crowding. 

Investigators concluded that despite the introduction of the ambulance diversion dashboard, ED crowding remained a persistent nationwide problem with limited impact from the dashboard due to its narrow focus and the influence of regional crowding. 

Source: intjem.biomedcentral.com/articles/10.1186/s12245-024-00784-1