PDSA

This fishbone diagram highlights several key factors that can contribute to ambulance offloading delays. It shows how unclear guidelines on Fit2Sit eligibility, insufficient training, and limited coordination between EMS and hospital staff can prolong offload times. Additional issues such as a shortage of available stretchers and high ED volumes also play a role. The circled root causes are the factors our solution aims to address.

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In particular, uncertainty around liability related to Fit2Sit and the shared responsibility between the triage nurse and EMS have been identified as major barriers. Although EMS personnel have the authority to designate a patient as Fit2Sit, concerns about potential liability and the expectation for triage nurse confirmation often lead to delays and underutilization of the program. By targeting these issues with enhanced training and clearer protocols, our solution seeks to empower paramedics to make confident, timely decisions and ultimately reduce offload delays while maintaining patient safety.