EMS 6 highlights revolving door issue in hospital discharge practices

The San Francisco City Council meeting held on July 4, 2025, focused on pressing challenges within the city's emergency medical services (EMS) and hospital discharge processes. The discussion highlighted significant issues regarding the treatment and placement of patients who frequently utilize emergency services.

One of the primary concerns raised was the phenomenon of patients being discharged from hospitals only to be transported back to emergency departments shortly thereafter. This "revolving door" situation occurs when individuals, particularly those with complex needs, are released without proper follow-up or placement options. EMS Chief Tong explained that many of these patients are tracked by EMS 6, which employs a case management approach to ensure ongoing support. However, when patients are discharged without prior notification to EMS, they often end up back on the streets, leading to repeated calls for emergency assistance.

The council members acknowledged the limitations faced by hospitals, which often discharge patients who do not meet the criteria for admission. This practice, while necessary due to hospital capacity constraints, contributes to the cycle of re-hospitalization. Chief Tong emphasized the importance of communication between EMS and hospital emergency rooms to improve tracking and follow-up care for these vulnerable individuals.

The meeting concluded with a commitment to enhance collaboration between EMS and hospital administrators to address these systemic issues. The council recognized the need for improved policies and procedures to ensure that patients receive the appropriate care and support they require after discharge, ultimately aiming to break the cycle of repeated emergency visits. Further discussions and actions are expected as the city seeks to implement solutions to these ongoing challenges.