City outlines EMS alert system, ambulance diversion goals and PulsePoint rollout

San Francisco’s Emergency Medical Services agency on Aug. 2 described a package of operational changes aimed at smoothing ambulance dispatches, reducing ambulance patient offload delays (APOD) and improving community cardiac arrest response.

Andrew Holcomb, acting EMS director, said EMS Alert — an automated successor to an earlier CADDI manual system — pulls live 911 data to distribute ambulances more evenly across the system and reduce surge events. "EMS alert is automatic, and takes real data from our 911 center and then pushes it into our ReadyNet system," Holcomb said, adding that the goal is to distribute ambulances across facilities more effectively rather than build additional ambulance capacity.

Dr. John Brown, EMS medical director, described the operational tradeoffs between ambulance diversion and long patient offload delays: if a facility diverts ambulances, other hospitals may face surges; if diversion is too low, ambulances can queue and lead to long offload times. The health department and hospital partners have adopted an APOD/diversion policy with interim improvement targets and aim for a system goal of roughly 30% diversion and a 30‑minute ninetieth‑percentile APOD as a benchmarking target while pursuing incremental improvements.

The agency also announced a PulsePoint mobile app rollout to alert trained community responders to public cardiac arrests and to show the nearest AED. Holcomb said the verified responder program will allow verified clinicians and off‑duty rescuers to be notified for residential events that are eligible under the program’s rules. The EMS agency plans community CPR training, kits distribution (mannequins and materials) and a CPR consortium to expand community bystander intervention.

Officials said staffing remains a constraint but noted progress: the Fire Department expects to hire about 60 additional EMS personnel to bolster response capacity. The agency also flagged long lead times for some equipment and the systemic need for more sobering and behavioral‑health alternatives to reduce ED boarding and ED diversion pressure.

Next steps: the EMS agency will continue implementation of APOD/diversion policies, expand verified responder and PulsePoint features and coordinate with hospitals on operational pilots to reduce both diversion and offload delays.