When a hospital is on diversion, it signifies a temporary change in its operational status. This status is an official communication that the facility is temporarily overwhelmed and cannot safely manage the incoming volume of emergency patients. Diversion is a mechanism intended to redistribute the patient load across a region to maintain safety standards during a period of stress.
What Hospital Diversion Means
Hospital diversion is a request made by the Emergency Department (ED) to local Emergency Medical Services (EMS) providers, such as ambulance companies, asking them to transport patients to an alternate facility. The primary meaning of this status is that the hospital’s resources are currently exhausted, and accepting more ambulance arrivals would compromise patient safety. However, a hospital on diversion is not closed; it cannot refuse care to an unstable patient who is brought in, nor can it turn away patients who arrive via private vehicle.
The status is communicated to EMS dispatch, which reroutes ambulances to the next closest open hospital. While ambulances are asked to bypass the facility, patients who arrive on their own will still be accepted for treatment, though they will likely face significantly extended wait times. Diversion is always a temporary, operational status, often requested in increments of a few hours, to allow the facility time to relieve pressure on its ED.
Common Triggers for Invoking Diversion
The decision to declare diversion status is rooted in a lack of resources needed to safely treat incoming patients. One frequent trigger is a lack of bed capacity, which results in admitted patients being held in the ED for hours or days. This phenomenon, often called “boarding,” ties up treatment bays, monitors, and nursing staff, quickly overwhelming the ED’s functional space and preventing the processing of new arrivals.
Another common cause is a critical staffing shortage, limiting the effective number of available beds due to a lack of nurses, physicians, or technicians. A lack of specialized staff—such as trauma surgeons or intensive care nurses—means the hospital cannot maintain a safe patient-to-staff ratio for new high-acuity cases. Similarly, the temporary failure or loss of essential medical equipment can necessitate a diversion request, such as when a computed tomography (CT) scanner or cardiac catheterization lab is non-operational.
The ED may also invoke diversion due to internal infrastructure issues, such as a major utility failure, flood, or fire within the hospital building itself. Cyberattacks that render electronic medical records (EMR) or imaging systems inaccessible have also forced facilities into a diversion status. These internal crises deplete the resources and staff attention needed for emergency care, making it necessary to temporarily reduce the patient load until the resource issue is resolved.
Impact on Patient Care and Receiving Facilities
Hospital diversion introduces systemic risks to timely patient care, particularly for individuals with time-sensitive medical conditions. When an ambulance bypasses the closest facility, the increased transport distance translates to delays in definitive care for conditions like severe trauma, stroke, or heart attack. For these conditions, every minute of delay can negatively affect a patient’s outcome and long-term prognosis.
The resulting strain on neighboring facilities creates a domino effect across the regional healthcare network. Receiving facilities must absorb the diverted patient volume, quickly pushing them to their own capacity limits and leading to internal overcrowding. This surge in patients can compromise the quality of care for all patients in the receiving ED by increasing wait times and stretching the staff-to-patient ratio. Consequently, the receiving hospital may then be forced to declare diversion itself, exacerbating the overall system congestion.