In January 2024, Assembly Bill 40 was passed, mandating hospitals to reduce ambulance patient offload time (APOT) to under 30 minutes 90% of the time. APOT is the interval between an ambulance patient’s arrival at the emergency department (ED) and the transfer of the patient to an ED gurney, bed, or chair, at which point the ED assumes full responsibility for the patient’s care.
At the time of AB 40’s passage, Kaiser Permanente’s ED had an APOT time of 88 minutes. In February 2024, an APOT summit was held to discuss the impact on the community, emergency medical services (EMS), the fire department, and local emergency departments.
An ED task force, consisting of frontline nursing staff, an EMS liaison, an EMS medical director, and the ED service line nursing director, collaborated to reduce APOT time to a target of 30 minutes. The group developed a model called Ambi ROAD (Rapid Offloading of Ambulances into the Department) to achieve this goal.
The initiative’s three objectives are to reduce APOT to 30 minutes or less, facilitate the transfer of care to return EMS personnel to the community, and obtain EKGs within 10 minutes of arrival for high-risk patients requiring immediate care. By May 2024, Roseville’s APOT time had dropped below 30 minutes and has been sustained.