Produced by the Sax Institute, Access block: A review of potential solutions analyses more than a decade of global research to ascertain four clear solutions for access block.

Access block, the situation where patients who have been admitted and need a hospital bed are delayed from leaving the emergency department (ED) for more than eight hours, is the root cause of hospital overcrowding, ambulance ramping, longer wait times, staff burnout and leads to poorer patient outcomes, including avoidable patient deterioration and deaths.

The four solutions identified by the report are:

  • Increasing hospital inpatient bed capacity, and improving patient flow and discharge processes, to allow hospitals to run at 85-90% occupancy.
  • Implementation of short stay units, acute medical units and acute surgical units, with adequate capacity to support timely inpatient admission, as well as early multidisciplinary clinical decision-making, for patients with complex or partially differentiated medical problems following their initial stabilisation, assessment and treatment in an ED.
  • Improved integration and coordination across the ED/inpatient interface, and the acute hospital/community interface, to smooth and expedite patient transition between sectors and services.
  • Adoption of health-system wide targets for patient flow, including differentiation of admitted and non-admitted patient transit times through EDs, applied with sufficient flexibility to assure patient safety and experience.

ACEM President Dr Clare Skinner said, “Emergency physicians know, without a doubt, that access block is a serious issue that impacts on patients, clinicians, carers and others – we know that access block harms patients and erodes clinician morale. Access block: A review of potential solutions identifies practical, and achievable solutions for the biggest problem in the Australian and NZ health systems.”

“We thank the Sax Institute for their work on the report, and look forward to working with government, hospital executives, patients, carers and all bi-national health stakeholders to implement the solutions identified. Working together, we can ensure all people across Australia and Aotearoa New Zealand get the fair, safe, accessible and affordable care they need, when and where they need it.”

Access block: A review of potential solutions is available to read in full here.


ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards.

The Sax Institute is an independent, not-for-profit organisation that improves health and wellbeing by driving better use of evidence in policies, programs and services.

Media Contact:

Melissa Howard [email protected] + 61 427 621 857