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 post-intervention change. The intervention was defined as commencing on 1st November 2024. Results A total of 187, 301 patients presented between 27 th December 2021 and 17 th March 2025, of which 55,802 (29.8%) were ambulance arrivals. Overall, 39.7% (95% CI 39.3, 40.1) of patients were offloaded within forty minutes 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 forty-minute 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 forty minutes.