Ambulance Arrivals and ED Flow - A Queensland Perspective

Area of Science:

• Health Services Research
• Emergency Medicine
• Public Health Policy

Background:

• Increasing burden on public health systems necessitates whole-of-hospital solutions.
• Limited research exists on the link between ambulance arrival metrics and emergency department (ED) crowding.
• Queensland Ambulance Service (QAS) manages patient distribution across multiple hospitals with a 30-minute Patient Off Stretcher Time (POST) target.

Purpose of the Study:

• To investigate temporal variations in POST performance.
• To examine the relationship between POST performance and ED crowding.
• To analyze ambulance arrival and ED patient arrival data.

Main Methods:

• Utilized ambulance arrival data from QAS.
• Analyzed ED patient arrival data from 15 major metropolitan hospitals in Queensland.
• Examined POST performance in relation to ED occupancy levels.

Main Results:

• A relationship was identified between ED occupancy and ambulances waiting at the ED door.
• Higher ED occupancy was linked to average POST at larger hospitals.
• No significant relationship was found between POST and ED length of stay, potentially due to National Emergency Access Targets (NEAT).

Conclusions:

• ED occupancy levels influence ambulance waiting times and POST performance, particularly in larger facilities.
• Further research and modeling are recommended to validate these findings.
• Optimizing patient flow requires understanding the interplay between ambulance services and ED operations.