San Francisco EMS offload times rise to 46 minutes; department exploring tech and partnerships
February 14, 2024 | San Francisco City, San Francisco County, California
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Deputy Chief Sandra Tong told the Fire Commission on Feb. 14 that ambulance patient offload times — the interval from ambulance arrival to transferring a patient to hospital care — climbed to 46 minutes in January, well above the department's 20‑minute goal.
"The goal is within a 90% of the time, 20 minute transfer time," Tong said while reviewing monthly EMS metrics. She noted the sequence of averages: roughly 34–35 minutes in November, 40 minutes in December and 46 minutes in January, and said the longer times reduce ambulance availability for subsequent 9‑1‑1 calls.
Tong attributed the delays to hospital bed availability and so‑called "boarding" — situations where the emergency department lacks capacity to move patients upstairs — and said the issue is both a local and statewide problem. The department described an existing EMS alert mechanism that notifies crews when hospitals are overloaded and said it is developing a real‑time bed‑availability application to help crews route patients more effectively.
Other EMS updates: Tong reported the department continues to operate four BLS pilot ambulances (24‑hour units) that share call volume with SFFD units and is evaluating the programor continuation. She said the department's eleventh paramedic academy began Jan. 8 with five recruits expected to graduate in March. Tong also highlighted an international medical mission led by EMT Carlos Martinez that deployed 12 SFFD members and served tens of thousands of patients with partner organizations.
Commissioners asked whether hospital ownership changes (notably UCSF's purchase of St. Francis and St. Mary's) might affect capacity; Tong said the hospitals are expected to continue as licensed emergency departments and that staffing and bed flow, not ownership per se, are the immediate drivers of APOT.
What comes next: The department will continue to measure APOT and work with hospitals through LEMSA and other committees, pursue technology to improve real‑time routing decisions, and report updates to the commission.
"The goal is within a 90% of the time, 20 minute transfer time," Tong said while reviewing monthly EMS metrics. She noted the sequence of averages: roughly 34–35 minutes in November, 40 minutes in December and 46 minutes in January, and said the longer times reduce ambulance availability for subsequent 9‑1‑1 calls.
Tong attributed the delays to hospital bed availability and so‑called "boarding" — situations where the emergency department lacks capacity to move patients upstairs — and said the issue is both a local and statewide problem. The department described an existing EMS alert mechanism that notifies crews when hospitals are overloaded and said it is developing a real‑time bed‑availability application to help crews route patients more effectively.
Other EMS updates: Tong reported the department continues to operate four BLS pilot ambulances (24‑hour units) that share call volume with SFFD units and is evaluating the programor continuation. She said the department's eleventh paramedic academy began Jan. 8 with five recruits expected to graduate in March. Tong also highlighted an international medical mission led by EMT Carlos Martinez that deployed 12 SFFD members and served tens of thousands of patients with partner organizations.
Commissioners asked whether hospital ownership changes (notably UCSF's purchase of St. Francis and St. Mary's) might affect capacity; Tong said the hospitals are expected to continue as licensed emergency departments and that staffing and bed flow, not ownership per se, are the immediate drivers of APOT.
What comes next: The department will continue to measure APOT and work with hospitals through LEMSA and other committees, pursue technology to improve real‑time routing decisions, and report updates to the commission.
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