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Introduction
—Solutions to access block
—Reducing demand
—Out of hospital
—In the emergency department
—Increasing capacity
—In the emergency department
—In the hospital
—Improving exit from the hospital
—Improved processes
—Increased capacity in the community
—Monitoring the system
—Non-solutions
—After-hours ambulatory clinics
—Nurse on call
—Ambulance bypass
—Conclusion
—Competing interests
—Author details
—References
Hospitals cannot manage their emergency patients when there is significant access block.
There are solutions that should be implemented but require national leadership to be effective.
These solutions include an immediate increase in the number of acute hospital beds, improved coordination and increased community capacity to manage medical patients with complex conditions outside acute public hospitals, improved hospital processes, and better standardisation of treatment within emergency departments.
There is little evidence that telephone triage, ambulatory care clinics or disaster management techniques, including ambulance diversion, reduce access block.
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©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377