A review on ambulance offload delay literature
- 7 July 2018
- journal article
- review article
- Published by Springer Science and Business Media LLC in Health Care Management Science
- Vol. 22 (4), 658-675
- https://doi.org/10.1007/s10729-018-9450-x
Abstract
Ambulance offload delay (AOD) occurs when care of incoming ambulance patients cannot be transferred immediately from paramedics to staff in a hospital emergency department (ED). This is typically due to emergency department congestion. This problem has become a significant concern for many health care providers and has attracted the attention of many researchers and practitioners. This article reviews literature which addresses the ambulance offload delay problem. The review is organized by the following topics: improved understanding and assessment of the problem, analysis of the root causes and impacts of the problem, and development and evaluation of interventions. The review found that many researchers have investigated areas of emergency department crowding and ambulance diversion; however, research focused solely on the ambulance offload delay problem is limited. Of the 137 articles reviewed, 28 articles were identified which studied the causes of ambulance offload delay, 14 articles studied its effects, and 89 articles studied proposed solutions (of which, 58 articles studied ambulance diversion and 31 articles studied other interventions). A common theme found throughout the reviewed articles was that this problem includes clinical, operational, and administrative perspectives, and therefore must be addressed in a system-wide manner to be mitigated. The most common intervention type was ambulance diversion. Yet, it yields controversial results. A number of recommendations are made with respect to future research in this area. These include conducting system-wide mitigation intervention, addressing root causes of ED crowding and access block, and providing more operations research models to evaluate AOD mitigation interventions prior implementations. In addition, measurements of AOD should be improved to assess the size and magnitude of this problem more accurately.Keywords
Funding Information
- Natural Sciences and Engineering Research Council of Canada
This publication has 122 references indexed in Scilit:
- Reducing Ambulance Diversion at the Hospital and Regional Levels: Systemic Review of Insights from Simulation ModelsWestern Journal of Emergency Medicine, 2013
- Evaluation of ambulance offload delay at a university hospital emergency departmentInternational Journal of Emergency Medicine, 2013
- Emergency Department Crowding, Part 1—Concept, Causes, and Moral ConsequencesAnnals of Emergency Medicine, 2009
- Systematic Review of Emergency Department Crowding: Causes, Effects, and SolutionsAnnals of Emergency Medicine, 2008
- The potential adverse patient effects of ambulance ramping, a relatively new problem at the interface between prehospital and ED careJournal of Emergencies, Trauma, and Shock, 2008
- Ambulance Diversion: Economic and Policy ConsiderationsAnnals of Emergency Medicine, 2006
- Ambulance Diversion and Lost Hospital RevenuesAnnals of Emergency Medicine, 2006
- When is a door not a door? The difference between documented and actual arrival times in the emergency departmentEmergency Medicine Journal, 2006
- Analysis of Ambulance Transports and Diversions Among US Emergency DepartmentsAnnals of Emergency Medicine, 2006
- The effect of emergency department crowding on paramedic ambulance availabilityAnnals of Emergency Medicine, 2004