Burke says the announcement of the diversion ban in June, 2008 forced hospitals to abandon a flawed strategy to address ED crowding and look at the problem from a new direction in the months before the ban was imposed.
"Several hospitals took that six months before the implementation of the ban to make some changes," she says. "We asked people informally what they did to prepare for the ban. There were all sorts of things to improve flow. Now hospitals have made these changes to improve patient flow and that led to decreases in patient crowding."
While pleased with the study's findings, Burke concedes it has "limitations" that might gloss over some wait time issues.
"We looked at medium monthly length of stay so there could be smaller isolated periods of crowding that our study doesn't take into account," she says. "We are not trying to say that the ban is going to cause your crowding to go down but in our study sample it didn't cause an increase in crowding."