TITLE: BYPASS STATUS - DIVERSION TO A HOSPITAL, TRAUMA CENTER OR REGIONAL TRAUMA CENTER OTHER THAN THE NEAREST HOSPITAL

POLICY STATEMENT:

Patients of EMS agencies affiliated with the BroMenn/St. Joseph EMS Systems shall not be transported to a hospital other than the nearest hospital, Regional Trauma Center or Trauma Center unless the EMS Medical Director or a qualified designee (Medical Control Physician) has certified that the medical benefits to the patient reasonably expected from the provision of appropriate medical tratment at a more distant facility outweigh the increased risks to the patient from the transport to the more distant facility, or the transport is in accordance with the EMS Systems Policy and Procedure for Patient Hospital Preference or Patient Right of Refusal.

GOAL/PURPOSE:

To clarify for Medical Control and pre-hospital care providers the bypass or the diversion of a patient to a hospital other that the nearest hospital, trauma center or Regional trauma center.

POLICY/PROCEDURE:

A. NO BYPASS OR DIVERSION OF AN EMERGENCY PATIENT(S) TO A HOSPITAL OTHER THAN THE NEAREST HOSPITAL UNDER ANY CIRCUMSTANCES WITHOUT MEDICAL CONTROL PHYSICIAN AUTHORIZATION IS PERMITTED. IT IS THE RESPONSIBILITY AND THE MANDATE BY ILLINOIS STATE LAW THAT THE MEDICAL CONTROL PHYSICIAN IS THE ONLY PERSON WHO MAY AUTHORIZE THE BYPASS OR DIVERSION OF A PATIENT(S).

B. Patients of EMS agencies affiliated with the BroMenn/St. Joseph EMS Systems shall not be transported to a hospital other than the nearest hospital, Regional Trauma Center or Trauma Center unless the EMS Medical Director or a qualified designee (Medical Control Physician) has certified that, the Medical benefits to the patient reasonably expected from the provision of appropriate medical treatment at a more district facility outweigh the increased risks to the patient from the transport to the more distant facility, or the transport is in accordance with the EMS Systems Policy and Procedure for Patient Hospital Preference pages 67-69, or Patient Right of Refusal pages 45-47.

C. The Medical Control Physician may determine a trauma patient may benefit from the authorize transport directly to BroMenn Regional Medical Center or St. Joseph Medical Center, both level II Trauma Centers; likewise, the Medical Control Physician may authorize transport directly to OSF St. Francis Medical Center - Peoria, or to Carle Foundation Hospital - Urbana, both level I Trauma Centers, rather than transport to the nearest hospital that is not a trauma center. This determination may only be made by the Medical Control Physician and in compliance with the time requirements as mandated in the Field Triage of the Trauma Patient policy, refer to pages 70-73 of the EMS Systems Policy and Procedure Manual.

D. If either of the Resource Hospitals, BroMenn Regional Medical Center or OSF St. Joseph Medical Center, both level II Trauma Centers has determined the need to initiate Trauma Center Bypass, the respective Medical Control, after proper notification, shall have all ambulances with trauma patients diverted to other hospital emergency departments. Both hospitals comply with the Region 2 Trauma Center Bypass policy, refer to pages 76-78 of the EMS Systems Policy and Procedure Manual.

E. REGARDLESS IF A FACILITY IS ON BYPASS STATUS OR NOT, A PATIENT IN A LIFE-THREATENING CONDITION SHALL BE TRANSPORTED TO THE CLOSEST FACILITY.

F. A hospital can declare a resource limitation under certain circumstances, (i.e., internal disaster, unavailability of critical or monitored beds). Seek Medical Control direction.

G. BYPASS STATUS MAY NOT BE HONORED if three or more hospitals in a geographic area are on bypass status and transport time by an ambulance to the nearest facility exceeds 15 minutes. Seek Medical Control direction.

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