Washington Bridge closure lengthened East Bay ambulance trips, study finds

Researchers used Rhode Island Department of Health records of 911 calls to compare how long ambulances took to reach patients, how long they took to reach hospitals and where patients were taken.

The closure also changed where some patients were taken, with emergency crews sometimes eschewing the bridge to transport patients who could be treated at other hospitals.

Patients in need of trauma, stroke or pediatric care were transported at roughly the same rates — largely because, as the study notes, “the State’s only adult trauma/comprehensive stroke center and children’s hospital are on the western side of the Washington Bridge.”

During the four days where “civilian traffic…completely halted,” ambulances were still allowed to cross the bridge one at a time, but their drivers had to call dispatch to gain approval to cross the bridge.

The hectic logistics of crossing the Washington Bridge in late 2023 presented the six-person research team “a unique opportunity to study both something that was impacting all of our daily lives and how EMS can operate during planned road closures, like parades or road races,” Dr. Kenneth Williams, adult medical director of Brown University Health’s LifePACT Transport Team, wrote in an email on behalf of himself and the study’s lead author Elise Solazzo.

The study notes that extra scrutiny was given to the 10,346 ambulance trips originating in East Providence, Barrington, Bristol and Warren — “the municipalities most likely to use this bridge.”

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That closer look at the East Bay data showed that, in these East Bay communities, average travel time from the scene to the hospital increased from 14.97 minutes before the closure to 17 minutes during the four-day shutdown. Even after the Rhode Island Department of Transportation (RIDOT) created two westbound lanes on the eastbound span, average travel time from the East Bay remained higher over the next six months, at 15.97 minutes.

There was no significant change in the time it took ambulances to reach patients in the East Bay.

East Bay patients were often taken to different hospitals as a result of the delays. While the study does not name the hospitals, East Bay patients who were in need of non-specialized care headed to one Providence hospital at a rate of 27.6% before the closure and 24.27% afterward. Ambulances instead increased trips to two hospitals that did not require crossing the bridge.

“Patients who needed specialty services — e.g., trauma, stroke, and pediatric patients -— had transport times most impacted by the bridge closure, which is likely because they couldn’t be rerouted to other hospitals and avoid taking 195,” Williams, who is also a professor of emergency medicine and EMS Division director at the Warren Alpert Medical School of Brown University, wrote over email.

“We need to support our EMS system so they can have the best possible resources to keep providing excellent care and minimize any potential impact of this delay,” Williams added.

EMS providers “did not reroute patients requiring specialty services,” the study notes. “While this is an encouraging finding for quality of patient care, it also means these patients were likely most impacted by increased scene-to-destination times from the infrastructure failure.”

The study notes that RIDOT’s permitting one-at-a-time ambulance crossings over the now defunct westbound span may have helped lessen the impact on travel times in the initial days of the closure.

“Notably, the magnitude of increase in scene-to-destination times was larger in the six months following the full bridge closure than it was during the acute phase of the bridge closure,” the study notes, adding that this was true even after RIDOT rerouted four lanes of traffic across one span of the bridge.

“RIDOT’s efforts to coordinate ambulance traffic over the affected bridge span were quite admirable,” Williams wrote. “They quickly established an efficient alternate route, and our study showed that the acute part of the bridge closure had minimal impact on EMS transport times. Though most infrastructure failures aren’t planned, that efficiency should remain the priority.”

Statewide data was not as pronounced as the East Bay data. Ambulance trips to reach patients increased by about 14 seconds, from 4.64 minutes before the closure to 4.88 minutes afterward. But time from the scene to the hospital actually fell, with average travel time going from 10.57 minutes to 10.04 minutes, although this was “unlikely to be clinically significant for the vast majority of EMS patients.”

Determining whether longer trips caused harm to patients was outside the study’s scope. The authors also noted in the study’s section on limitations that data from neighboring towns in Massachusetts which also use Providence hospitals was not included, which means the study “may underestimate the full regional impact of the closure.”

The authors concluded that “the effect of infrastructure failures on EMS transport time may not be as far-reaching as initially expected,” given RIDOT’s quick work to preserve ambulance access and the ability of EMS workers to reroute to different hospital for general ER care.

“The results suggest infrastructure failures are likely to be most consequential for patients requiring transport to a specialty center for specific care,” the study authors noted.

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