Paramedic PapersHome Operations & systems Ramping driven by hospital 'back door'
Operations & systems
Ramping driven by hospital 'back door'
Access Block and Ambulance Ramping: The Canaries of the Healthcare System
Emergency Medicine Australasia · Added 8 September 2026
A mixed-methods Queensland study of six years of ambulance and hospital records found access block is largely a hospital discharge ('back door') problem, with recommendations spanning discharge metrics, primary care support and prehospital flow.
- Study type
- Other
- Design
- Mixed-methods study: umbrella review, qualitative interviews and quantitative analysis of six years of health system records
- Participants
- 25 largest public hospitals in Queensland; patients and healthcare workers (numbers not reported)
- Main finding
- Access block is largely a hospital discharge ('back door') problem; recommendations include inpatient discharge metrics, primary/community/aged care support, hospital-in-the-home alternatives, prehospital flow investment, extended-hour discharge lounges and funding reform
- Caveat
- Queensland-specific health system data; mixed-methods design not a controlled evaluation of interventions
- Bottom line
- Hypothesis-generating
Why it matters in Australia (High relevance). transferability — the best local evidence yet on what drives the ramping every crew experiences
Learning goal
Understand how hospital discharge bottlenecks drive ambulance ramping and what system-level responses could ease patient flow.
More
- Topic: Operations & systems
- Daily scan: 8 September 2026
Related papers on Operations & systems
-
2026 review of prehospital guideline quality
The 2026 update of the systematic review appraising evidence-based guidelines for prehospital care — abstract not yet available (ahead-of-print), but this recurring review is the reference map of what guideline-level evidence exists in prehospital practice.
-
ED volume not linked to mortality
Cohort of 724,256 ED presentations across Dutch and Danish hospitals — annual ED volume had no association with in-hospital mortality, while mortality was lower on busier days, driven by excess deaths on quiet ones.
-
AI predicts ED admitting team from triage notes
Sydney single-centre deep learning study of 40,054 admitted ED patients — a fine-tuned clinical language model predicted the inpatient admitting specialty from triage notes with AUROC 0.97, though precision was a moderate 0.71.
-
ED ultrasound archiving works in Australia
Four-year implementation study of a middleware ED ultrasound archiving and QA workflow at Nepean Hospital — 7,281 studies archived across 15 modalities with zero data loss or failures, automated trainee logbooks saving each trainee ~2 h/week, and clinician time (not software) the dominant recurring cost.