Ambulance Offload Delay and the Offload Zone: An Empirical Analysis of the Effectiveness of an Offload Time Reduction Effort

Abstract

When ambulances arrive at a crowded emergency department (ED), paramedics must wait with the patient until ED space opens, causing offload delay and reducing the number of ambulances available to the community. An Offload Zone (OZ) is a monitored waiting space for ambulance patients, designed to reduce offload delay and allow ambulance crews to return to service more quickly. The implementation of OZ-style concepts has been trialled around the world, but it is not clear why these efforts often have mixed results. In this analysis, data reflecting patients’ journeys through the ED are analyzed to show how the OZ affects the ED as a system and patients as individuals. Data from two hospitals in Halifax, Canada are contrasted to highlight differences in their OZ implementations and results. This study finds that these hospitals reduced offload delay to a certain extent, and identifies systemic factors that can lead to OZ issues.