Hospital Patient Offload Performance (APOT)
Stockton City Council
Meeting August 18, 2026
Agenda Item 10.6
Presented by
Lonnie Gutierrez
Division Chief, EMS Division | Stockton Fire Department Executive Director | CENCAL Fire & EMS Authority
And Medical Patient Destination
1 What is APOT?
Ambulance Patient Offload Time measures the transfer from EMS care to hospital care. 911 Call
Response
Patient Care
Transport
Hospital Arrival
APOT
Transfer of Care
Back in Service
Local standard
25 minutes
SJCEMSA Policy 4985 requires
hospitals to accept transfer of
care promptly, but not later
than 25 minutes after arrival.
APOD occurs when APOT
exceeds the standard
established by the Local EMS
Agency.
Faster transfers return
ambulances to the 9-1-1
system sooner.
Stockton Fire Department • CENCAL Fire & EMS Authority 2 2 Why APOT Matters
APOT is not just a hospital metric - it directly affects ambulance availability.
Ambulance
Availability
Ambulances remain
committed until the
hospital assumes patient
care.
Response
Reliability
Longer transfer times
reduce the number of
available units in the
system.
Public
Safety
Efficient transfers improve
readiness for the next 9-1-
1 emergency.
Every minute saved returning an ambulance to service strengthens emergency response for the community.
Stockton Fire Department • CENCAL Fire & EMS Authority 3 3 Stockton Fire Department • CENCAL Fire & EMS Authority 4 4 5
Goal: improve ambulance
availability while
maintaining patient care.
Source: SJCEMSA 2025 Annual Report - Ambulance Patient Offload Delays; SJCEMSA Policy 4985.
Stockton Fire Department • CENCAL Fire & EMS Authority 5 6 Moving Forward
The current collaborative process remains the right framework for continued improvement.
Partnership
Continue working with
SJCEMSA, hospitals, AMR,
CENCAL and regional fire
agencies.
Performance Monitoring
Use weekly APOT
reporting and quarterly
advisory meetings to
review trends.
Public Safety
Return ambulances to
service faster for the next
9-1-1 emergency.
Ambulance Patient Offload Time is not solely a hospital performance measure - it is a shared public safety responsibility.
Stockton Fire Department • CENCAL Fire & EMS Authority 6 7