Comment Re:It's Not Just Any Beaurocracy (Score 5, Informative) 406
"Turning away ambulances" is not how it really happens. Let me describe it for you:
The hospital determines it is nearing its capacity to handle emergent cases. The hospital contacts the regional EMS dispatch to let them know. In my area, this is the county Fire Control. When an ambulance calls in that they have arrived on scene, the dispatcher will say, in this case, "Methodist Hospital is the only closed facility." The crew will let the patient know that they can't take them to that hospital. Also, when the crew calls dispatch for a clearance to transport the patient, if the hospital they are going to is closed, dispatch will tell them so (in NY, a patient can demand to be transported to even a closed hospital, but we do our best to convince them to go somewhere else). A hospital ED cannot turn away patients at the door, even if they come by ambulance.
So what if its a truly life threatening situation that can't be stabilized in the field? Say, full cardiac arrest, or uncontrollable arterial bleed? The ambulance will go to the closest facility, even if that is the closed facility, and will not be turned away. The ambulance will contact the receiving hospital directly and give a report on route, giving the hospital time to clear an appropriate room and mobilize the necessary staff to receive the patient.
Hospitals can close for a lot of reasons. Sometimes, a few staff members call in sick and they can't find coverage, so the capacity of the system is reduced. Sometimes a lot of patients come in all at once. Sometimes the hospital's support systems like EMR fail, but it could even be their admissions and billing system that decides to fail and causes the hospital to divert patients. It happens, but the system is designed to handle it.