Publication Date
Spring 2026
Degree Type
Doctoral Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Denise Dawkins
Keywords
Emergency Nursing, Ambulance Offload; Transfer of Care
Abstract
Emergency departments (EDs) worldwide are experiencing increased utilization resulting in care delays for patients seeking urgent treatment. Despite critical circumstances that warrant emergency medical services (EMS) response, patients arriving to the ED via ambulance remain vulnerable to delays in care due to prolonged ambulance patient offload times (APOTs). The amount of health care providers and treatment space necessary to initiate care are both limited and often strained resources which dictate the need for innovative interventions to prevent patient harm. The following project outlines the interventions implemented at the project site to improve APOT as a means to enhance patient safety and maintain congruency with recent legislation. Project interventions included the creation of a nurse role and offload area aptly named Ambi ROAD, an acronym for Rapid Offload to Avoid Delays. The use of the designated nurse and offload area allowed for the prompt initiation of treatment for patients who arrived via ambulance. Post-intervention figures denoted a 62% and 59% decrease in 90th percentile APOT mean values for the two local EMS agencies servicing the project site when compared to the prior year. Project results demonstrated a statistically significant improvement in the time required to complete the transfer of care from EMS to ED providers, thus supporting expedited patient treatment and the timely return of EMS personnel to the community.
Recommended Citation
Manguil, William J., "Building a ROAD to Mitigate Ambulance Patient Offload Time (APOT)" (2026). Doctoral Projects. 215.
DOI: https://doi.org/10.31979/etd.828b-meqa
https://scholarworks.sjsu.edu/etd_doctoral/215
