Slashing ambulance offload targets won't "fix a thing" when it comes to improving hospital care, an expert says.
Victoria has consistently failed to meet its target of transferring 90 per cent of patients to emergency departments within 40 minutes.
Researchers in the Medical Journal of Australia last week suggested that target should be scaled down to as low as 15 minutes.
Their study found mortality increased with transfer times of more than 17 minutes for patients with chest pain, and ramping may have been associated with up to 70 preventable deaths in 2018 alone.
However, cutting the target to 15 minutes would not solve the problem, Victorian emergency doctor Simon Judkins argues, pointing out paramedics need somewhere to offload patients.
"We've seen during COVID ... we created ambulance offload spaces within the hospital system, where we can free up ambulances and get them back out into the community where they should be," Dr Judkins told industry publication InSight+.
Instead, the areas within emergency departments were not properly staffed.
Patients were left waiting hours with paramedic trainees or nursing staff, rather than ambulance crews, Dr Judkins said.
"It's not solving the problem, it's just creating a bigger queue in front of the hospital."
Rather than focusing on ambulance targets, he said national authorities should look at whole-system reform, so hospitals run at 90 per cent capacity with beds always available for emergency patients.
"We're staffing (the ED) 24 hours a day, seven days a week. The rest of the hospital health system seems to be still operating on an 8am until 6pm, Monday to Friday continuum" Dr Judkins said.
"To say just offload ambulance patients quicker isn't going to fix a thing."
While a lower hospital transfer target would not be unwelcome for the Victorian Ambulance Union, the focus needed to be on hitting the existing target consistently, assistant secretary Olga Bartasek said.
Key performance indicators should be aimed at driving innovation across the health system, and preventing handballing of patients from one service to another.
She agreed with Dr Judkins about the need for whole of system reform.
"Changing KPIs won't help if everyone comes through emergency departments for the care they need."
On the original report findings, an Ambulance Victoria spokesperson said the organisation works with all hospitals to transfer patients as promptly as possible.
It is putting strategies in place to relieve pressure on the system, including rapid offload escalation measures and patient offload teams.
A Victorian government spokesperson said the healthcare system had been under an "unprecedented amount of pressure" due to the COVID-19 pandemic, deferred care and a spike in influenza.
"Our Pandemic Repair Plan includes getting more paramedics on the road, more Triple Zero call takers, expanding emergency departments and the training and recruitment of up to 7,000 healthcare workers to reinforce our health system," the spokesperson said on Monday.
That plan, as well as system changes and programs like Better at Home, Covid Positive Pathways and the Virtual Emergency Department run out of the Northern Hospital, would decrease pressure on emergency departments and ease ramping issues, they said.
Opposition health spokeswoman Georgie Crozier said the state needs system-wide solutions to increase hospital capacity and respond quicker to people in emergency health situations.
"Frontline staff continue to do outstanding work but have been hamstrung by insufficient resourcing and support by the current government," she said on Monday.
Australian Associated Press
Sign up for our newsletter to stay up to date.