An Initiative to Reduce Ambulance Offload Delays in an Australian Emergency Department-A Time Series Analysis.

BACKGROUND

Ambulance offload delays result in poorer patient-level outcomes and decreased availability of emergency medical services for the community.

OBJECTIVE

This study aims to measure the effect of a dedicated intervention to improve ambulance offload.

METHODS

This study is an improvement initiative from November 2024 that streamlines offload based on agreed criteria, in-person physician review, and early treatment room access. Dynamic regression techniques were used to measure the postintervention change. The intervention was defined as commencing on November 1, 2024.

RESULTS

A total of 187, 301 patients presented between December 27, 2021, and March 17, 2025, of which 55,802 (29.8%) were ambulance arrivals. Overall, 39.7% (95% CI 39.3, 40.1) of patients were offloaded within 40 min of arrival. The intervention period was associated with a 16.4% (95% CI 12.0, 20.7, p < 0.0001) increase in the proportion of ambulance patients who were offloaded within the recommended 40-min timeframe.

CONCLUSION

Empowering triage staff with predetermined offload criteria and access to early in-person physician review increases the proportion of ambulance patients being offloaded within 40 min.