Once regarded as a symptom of winter flu season, diverting ambulances during overcrowded shifts has become business-as-usual for many Tristate hospitals.

        Friday afternoon, the Christ, University and Deaconess hospitals were “on diversion” at the same time — and officials said it was nothing unusual.

        While statistics are not available for July, the number of diversions announced in June was up 56 percent compared with May, and up 360 percent compared with June a year ago, according to the Greater Cincinnati Health Council.

        From March through June — a time when large numbers of flu cases would not be expected — the number of diversions at local hospitals jumped from 52 in 2000 to 255 this year, the health council reported.

        “The bed capacity issues and the staffing issues aren't going away with the winter,” said Colleen O'Toole, vice president of the health council. “It looks like we're also beginning to see our aging population showing its age,” with increased demand for health services.

        A diversion means that a hospital has sent word through a countywide emergency communications system that life squads should try to avoid the facility for all or part of an eight-hour shift. The policy is voluntary and includes exceptions, such as trauma centers accepting severely injured, unstable patients.

        Many months have a day when at least four hospitals go on diversion at the same time. Having three on diversion at once occurs several times a month, Ms. O'Toole said. The record is seven at once Feb. 13.

        The diversions occur for various reasons. Sometimes, a flu outbreak, a natural disaster or a sudden rush of patients overwhelms a hospital. More commonly, hospitals can't hire enough staff for intensive care units or other key services, which causes back-ups in emergency departments.

        While many patients spend extra hours in emergency departments, there have been no deaths linked to diversions.

        However, hospitals may struggle to handle any surge in winter flu cases. Hospitals did not need to use an emergency plan developed last year because the flu season turned out to be milder than predicted. Hospitals have started updating that plan for this fall, Ms. O'Toole said.

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