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Ambulance Victoria’s 2021 Clinical Response Model: An evidence-based approach to improve ambulance resource allocation and response performance during the COVID-19 pandemic Ambulance Victoria

Team: Nicole Magnuson, Dr Ziad Nehme, Dr Shelley Cox, Tash Alexander, Emily Mahony, Emily Nehme, Kavitha Sathish-Kumar

In Victoria, easing of COVID-19 restrictions in 2021 led to surges in ambulance demand and compounding hospital delays, impacting Ambulance Victoria’s (AV’s) ability to provide a timely response to time-critical patients. This is a universal challenge faced by all ambulance services across Australia and New Zealand.

Optimising response performance under these evolving challenges requires a renewed emphasis on the appropriate prioritisation and dispatch of emergency ambulances. To address this challenge, AV conducted a review of its Clinical Response Model (CRM), or dispatch grid, using an established and internationally adopted framework. This comprehensive review focussed on identifying call types with a high volume of low acuity patients which could be diverted to Secondary Triage, where a nurse or paramedic further determined the need for emergency ambulance dispatch.

The intervention, implemented in September 2021 (at the height of the COVID-19 pandemic), was designed to:

1) Reduce the number of calls for which an emergency ambulance was dispatched.

2) Increase the number of calls managed through alternative service providers.

3) Improve response time performance to time-critical patients.

4) Better align the operational response with patient acuity.

The intervention represents a clinically safe, replicable, and cost-effective method for optimising dispatch prioritisation decisions. In Victoria, these CRM changes are now embedded into normal business with routine post-implementation safety monitoring. The initiative is an easily transferrable model of dispatch reform that can be implemented into ambulance services internationally, supporting the ongoing response to the pandemic.

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