In Queensland, access block was first observed in the peripheral urban hospitals in the Brisbane and Gold Coast area. As the absolute and relative bed capacity of public hospitals declined in the period 1999–2002, access block in Queensland's largest hospitals increased from a barely manageable average of less than 10% (Australasian College for Emergency Medicine/Australian Council on Healthcare Standards definition: proportion of admissions with total time in the emergency department longer than eight hours) to an average of about 14% in financial year 2001–02. Various administrative analyses have shown that the deleterious effects of access block start to become apparent at levels greater than 5%, and that these dysfunctional levels of access block occur when hospital occupancy consistently exceeds 95%. Other observations on Queensland data are that, generally speaking, access block is less of a problem in provincial centres than in metropolitan areas, and that hospitals with the best elective surgery performance tend to have the worst access block performance, and vice versa.
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- Clinical Administration, Royal Brisbane Hospital, Brisbane, QLD.