Reducing EMS Wall Time: Practical Steps to Improve ED Handoffs

EMS teams are responding quickly, providing high-quality care in the field, and arriving ready to transfer patients—only to get stuck waiting at the hospital.

Offload delays don’t just frustrate crews. They reduce unit availability, increase response times for the next call, and put pressure on the entire emergency care system.

The good news: improving EMS-to-ED handoffs doesn’t require more radio traffic or extra steps for crews. It requires a clearer, more consistent workflow that both EMS and ED teams can follow—especially during peak hours.

Why EMS Offload Delays Happen

Offload delays usually aren’t caused by one single issue. They come from multiple breakdowns happening at once:

• ED capacity constraints (beds, hallway space, staffing)
• Unclear ownership of the handoff process
• High-acuity interruptions pulling staff away
• Communication gaps between EMS, triage, and charge nurse
• No shared visibility into patient transfer status

When the ED is overwhelmed, handoffs become vulnerable to delays—especially when communication relies on radio updates or repeated phone calls.

Where the Handoff Breaks Down Most Often

Even when teams have a “handoff process,” delays happen when key steps aren’t visible or confirmed.

Common friction points include:

• Arrival isn’t clearly captured: ED teams may not immediately know who arrived, where the patient is, or how urgent the case is.
• No clear receiving role: Crews wait because it’s unclear who is taking report.
• No closed-loop confirmation: A report is given, but no one confirms receipt or next steps.
• No timestamping: Without consistent timestamps, delays become “normal” and hard to improve.

What a Better EMS-to-ED Handoff Looks Like

A strong handoff workflow should accomplish three things:

1. Visibility: Everyone knows the patient arrived and what’s needed next.
2. Closed-loop communication: Requests are acknowledged and confirmed.
3. Clear accountability: Roles—not individuals—own next steps.

The goal isn’t more communication. It’s better communication.

Practical Ways to Reduce Offload Delays (Without Adding Work)

Here are steps EMS and ED teams can align on that reduce waiting and improve flow:

1) Standardize handoff milestones

Even a simple set of milestones improves clarity:

• EMS arrival time
• Transfer of care started
• Transfer complete
• Unit back in service

2) Use a consistent report structure

Whether your system uses SBAR, MIST, or another format, consistency helps speed:

• chief complaint + acuity
• key interventions
• vitals trends
• immediate concerns
• recommended next steps

A consistent structure reduces repeat questions and improves safety.

3) Reduce the “who’s receiving?” confusion

One of the biggest sources of delay is the moment crews ask:
“Who is taking this patient?”

A defined receiving workflow (triage nurse vs charge nurse vs designated receiver) prevents unnecessary waiting.

4) Define escalation when delays occur

Escalation shouldn’t depend on repeated calling. It should be built into the process:

• If no receiver in X minutes → escalate to charge nurse
• If still delayed → escalate to flow coordinator/leadership

Metrics That Show Improvement

If you want to improve offload time, track a few key metrics:

• EMS offload time (arrival → transfer complete)
• Ambulance turnaround time (arrival → back in service)
  
  
• Time-to-receiving nurse
• Escalation frequency

Even 30 days of consistent tracking can reveal patterns like peak-hour delays or shift-change slowdowns.

Quick Takeaway

Offload delays are often a workflow visibility problem—not an effort problem. With clear milestones, closed-loop handoffs, and role-based accountability, EMS and ED teams can reduce delays without adding radio traffic or burdening crews.

About GD [General Devices]

GD is a HealthTech company specializing in communication solutions that help EMS and hospitals deliver simply seamless patient care. Powered by responsive innovation, GD’s user-friendly solutions facilitate rapid, secure, voice, telehealth and data sharing communications across care teams to help save time, money and lives. Backed by a 40+ year history and thousands of implementations, GD is an experienced industry leader. Visit https://general-devices.com/ to learn more.

Media Contact
Alessia Ambrosino
201-313-7075