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Ambulance Victoria Offload Delay (AVOD) Escalation Framework

October 25, 2022

In our continued effort to reduce Ambulance Offload Delays (AVODs) across our Emergency Departments, the AV Offload working party has created an AVOD escalation framework.  This new framework will commence as of the 26th October 2022, and will be further reviewed the week starting 28th November.  Your thoughts are important to us and we would love to hear your feedback.  Closer to the review time we will send out an email requesting your feedback and suggestions.

The aim of the AVOD Escalation Framework is to:

  • To maintain safety within the ED for patients and staff
  • To ensure that patients are off loaded under 40 minutes and Ambulances are released back into the community
  • To ensure any AVODs are escalated as per the guideline
  • To ensure the ED team feels supported to avoid or resolve any AV off load delays


AVODs occur when the care of incoming ambulance patients cannot be transferred immediately from paramedics to staff in a hospital emergency department (ED). Typically, AVODs are caused by emergency department crowding, acuity, or lack of inpatient bed capacity. AVOD escalation aims to reduce Ambulance Victoria’s (AV) wait times and improve offload performance against the DHS performance targets (90% of all patients who arrive via ambulance offloaded within 40 minutes).


The guiding principles for resolving or avoiding AVOD’s involve mobilising the Emergency Department and wider hospital teams where required in order to create space to facilitate offload.  This means ensuring an appropriate location, with the right resources available for the patient is found or created, to allow patients arriving via Ambulance to be offload in under 40 minutes. It is important to note, the 40-minute offload time starts from the AV Arrival Time (which can be from the time AV are reversing into the AV bay) and not the triage time.  The 40 minutes ceases at the agreed Ambulance Handover Time as documented in EDIS.


For more information please refer to the QRG;

Ambulance Offload Delay (AVOD) Escalation

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