Breakthrough report on ambulance ramping

The underlying causes and knock-on effects of ambulance ramping at Queensland hospitals are explored and analysed in a ground-breaking report published today by the Griffith Health Institute.

In the first official study of the phenomenon and the practices associated with ambulance ramping, researchers from Griffith University examined its impact on the delivery of emergency health services across South East Queensland.

“Essentially, ambulance ramping was found to occur when no suitable emergency department bed was available, nor able to be made available, for patients presenting by ambulance and a patient remained under the care of ambulance personnel,” Dr Ramon Shaban (pictured), Senior Research Fellow at Griffith’s Research Centre for Clinical and Community Practice Innovation, said.

The three-year study evaluated the effects of ambulance ramping on how emergency departments functioned, on ambulances services and on the delivery of emergency health services, based upon the results of interviews with health service employees.

It found that definitions of ambulance ramping varied depending on the hospital, the service and the individual health care workers.

“The findings indicate that ambulance ramping is a consequence and manifestation of emergency department overcrowding, and that considerable inconsistencies exist in how it is defined and reported across the health sector,” Dr Shaban said.

Overwhelmed resources at the point of triage and delays while emergency department patients were moved to accommodate incoming patients were reported to lead to delays in ambulance off-stretcher times.

Perceived consequences of ambulance ramping were also explored. Occupational stress, staff burnout and a blurring of professional boundaries were among the reported impacts on the workload of hospital and ambulance staff.

Physical and verbal violence directed towards staff was also reported. “Staff expressed concern they were unable to provide optimal treatment for patients and fulfil their roles as health professionals,” Dr Shaban said.

The findings of the research have already informed the establishment of a standard working definition of ambulance ramping. “The development of a clear definition establishes a basis through which the phenomena and practice can be further explored,” Dr Shaban said.

The report also provides an evidence base for future work such as that to be undertaken by the Metropolitan Emergency Department Access Initiative recently established by the Queensland Government.

Read the full report at: