Paramedics will be asked to treat multiple patients at emergency departments more often in order to free up other ramped ambulance crews and ease what a senior minister has described as one of the biggest issues plaguing Victoria’s health system.
The expectation is just one plank in the Allan government’s latest plan to tackle ambulance ramping, which is when paramedics have to wait at a hospital’s entrance because their patients cannot be transferred to the emergency department in a timely manner.
Victoria’s health minister wants to see a 4 per cent improvement in patient offload times by July 1. Credit: Luis Enrique Ascui
Health Minister Mary-Anne Thomas unveiled the strategy on Tuesday as part of a suite of new patient transfer standards that will be rolled out across Victoria’s busiest health services.
Hospitals have been told to reduce their patient offload times by 4 per cent by the end of this financial year or their emergency departments will be placed under “intensely monitored” improvement plans.
“If we are to end ramping, then we can’t keep doing things the way we’ve always done them,” Thomas said.
The government wants 90 per cent of patients who arrive at a hospital by ambulance to be handed over within 40 minutes and for ambulances to be back on the road within 20 minutes of a transfer.
Ramped paramedics treating multiple patients was a measure introduced during the pandemic, but the new standards will require this to happen more often across the state.
The guidelines, largely based off how staff operate at Melbourne’s Austin Hospital, will allow emergency physicians to admit patients directly to wards, and there will also be standardised guidelines for directing people to urgent care clinics. It’s hoped both measures will help free up space in emergency department waiting rooms, a major contributor to ramping issues.
Thomas on Tuesday shrugged off any suggestion that the reforms were proof that Victoria had not been following the best patient transfer practices until now. The Labor minister insisted the changes were instead about standardisation and gradual improvement.
“What we’re on about is scaling up what we know works. And that’s what the standards will deliver.”
Health Minister Mary-Anne Thomas says she will meet with hospitals which don’t meet their patient transfer targets. Credit: Simon Schluter
The minister said the government would eventually publish data on how well hospitals were meeting the new standards, but this wouldn’t be done immediately, despite the guidelines coming into effect for the state’s 17 busiest emergency departments this week.
Thomas added that hospitals wouldn’t need more money to implement the standards.
“They’ve got the resources that they need. It’s about changing … what they already do.”
Victorian Ambulance Union secretary Danny Hill welcomed the new standards but said hospitals had to be held accountable.
“Some hospitals really work hard to get paramedics back on road, but there are others that have seemed oblivious to the work paramedics need to do in the community,” Hill said.
“The success of these standards will depend on accountability. The honour system hasn’t worked. There needs to be a firm requirement to comply with the new standards to ensure paramedics don’t spend their entire shift ramped at hospital.
“Placing a senior doctor at triage, having decision-makers involved on arrival, fit to sit, are all measures that have worked well in other services so it’s good to see it happening here.
“On occasion, paramedics will look after more than one patient in a hospital corridor, but this is not a long-term solution. That work should be performed by hospital staff, not paramedics.”
The announcement was made on the same day that Victoria’s health information agency released its latest quarterly data on ambulance transfer times. The median transfer time was 27 minutes between October and December last year, down from 30 minutes the previous quarter.
But Coalition health spokeswoman Georgie Crozier said the latest transfer times were the same as January to March 2024.
“The government keeps shifting blame, but the reality is patients are still waiting too long for care,” Crozier said.
“Instead of fixing the root causes, the government’s response has been to penalise health services for failing to meet targets. It shouldn’t be this hard to get patients transferred and treated on time.”
Ambulance Victoria chief executive Andrew Crisp said all paramedics wanted to get back on the road and keep their communities safe.
“When it’s safe to do so, if we can use one or two paramedics to look after more than one patient, we will definitely be looking at doing that,” Crisp said.
“These standards are so important to get consistency across our health system.”
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