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Revamping the Ambulance Victoria Offload Model of Care at SHED

April 30, 2022

On Monday the 2nd May we will be revamping the Ambulance Victoria Offload Model of Care as a strategy to improve the impact of long Ambulance offload delays on patient care.

The AV offload Zone, formally known as the ‘Old EOU’ is a nine bed bay. The aim of the AV offload Zone is to initiate patient assessment, complete observations, provide clinical support and commence appropriate patient care and investigation whilst waiting for an admission to an appropriate areas such as Emergency Department/Short Stay Unit (SSU)/ Fast Track (FT)/ Rapid Assessment and Discharge (RADU) or discharge home.  The primary aim of the AV Offload zone is to support the timely offload of ambulance resources at SHED.  By increasing the percentage of patients off loaded to the care of a registered nurse (RN) within the AV offload zone within the targeted time of less than 40 minutes enables AV crews to respond to the community needs in a timely manner.

The AV Offload zone has a nursing ratio of 1:3.  To provide support and oversight as well as to ensure clinical safety, an Intermediate or Senior nurse who is credentialed in Adult Life Support (ALS) should be allocated to the AV Offload Zone.  This staff member will be supported, typically by either; West Metro Graduates/ RN’s or Graduate RNs.  The Green Consultant and Green medical team are responsible for medical care of the patients that are allocated to the AV Offload Zone.

Prior to considering whether a patient is suitable for handover to the AV Offload Zone, the Department of Health ‘Fit to Sit’ guidance should first be applied to identify patients suitable for allocation to the waiting room

Exclusion criteria for AV off load Zone & Adult Waiting Room

  • ATS CAT 1 or 2
  • Under the age of 18
  • Compromised GCS
  • Abnormal vital signs – meeting UCR or MET call criteria
  • S351 or on Mental Health Order (Assessment Orders (AO)/Temporary Treatment Order (TTO)Varied Treatment Order (VTO)
  • Requiring isolation precautions

Vulnerable patients – dementia, agitation, BOC >1, high falls risk, severe pain

Patients Suitable for the AV Offload Zone

·        Adult patients triaged as Category 3, 4 or 5
·        Chest pain with NO pain or arrhythmias
·        Haemodynamically stable
·        Able to safely wait in a bed
·        C-spine precautions cleared by doctor
·        Requiring ongoing IV fluids, analgesia or antibiotics
·        Deemed clinically safe by Triage Nurse

The AV – WH APOT Model of Care is included below

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