Verlust von Einsatzkapazität durch schlechte Metrik‑Transparenz

Definition

Australian ambulance performance has historically been reported mainly via simple indicators like **response time**, which provide a poor reflection of true quality and little direction for quality improvement.[3] In parallel, governments publish ramping and transfer‑of‑care metrics that show persistent under‑performance and large blocks of time where ambulances are waiting at hospitals instead of being available for new calls.[2][5][6] The AMA’s 2025 Ambulance Ramping Report Card documents that in multiple states and territories, only around **47–78%** of patients are transferred from ambulance to ED within 30 minutes, far below longstanding targets such as 90% within 30 minutes.[2] In the NT, ambulances spent **8,672 ramped hours** outside hospitals in 2023–24 alone.[2] Victoria separately tracks an “average ambulance clearing time”, with performance deteriorating from a 20‑minute target in 2019–20.[2] These are direct measures of lost fleet capacity. At the same time, the Productivity Commission’s Report on Government Services (RoGS) sets an indicator framework for ambulance services across Australia, requiring standardised reporting of performance data.[5] Research on Australian prehospital care quality indicators notes that services have relied on easily measured yet evidence‑poor metrics (mainly response times), and that the national indicator set is too narrow for modern quality management.[3] This gap means contract quality reports often do not expose specific, actionable inefficiencies such as avoidable ramping or clearing delays by contract, hospital, or time of day. Using the NT example of 8,672 ramped hours in 2023–24 as a benchmark, and assuming an average blended crew and vehicle operating cost of **AUD 250–300 per hour** (typical for advanced life support units when labour, fuel, maintenance and overheads are included – logic estimate), the direct operating cost tied up in ramping in that small jurisdiction alone is roughly: - 8,672 hours × AUD 250 ≈ **AUD 2.17 million** per year (lower bound) - 8,672 hours × AUD 300 ≈ **AUD 2.60 million** per year (upper bound) Across all states and territories, where annual incident volumes total **4.1 million incidents** and **3.5 million patients** treated or transported,[4] the ramped hours and extended clearing times are likely an order of magnitude larger (logic extrapolation). If we conservatively assume that inefficient ramping and clearing equivalent to just **0.5–1.0% of clinical hours** is avoidable with better, contract‑level metrics and active management, this translates into approximately **5–10% of effective fleet capacity** in high‑pressure hospitals and local contract areas being lost to unmanaged delays. For a metropolitan service operating 100 ambulances at 24 hours per day (≈876,000 unit‑hours per year), a 3% avoidable loss from unmanaged ramping and clearing delays is about: - 26,280 unit‑hours × AUD 250 ≈ **AUD 6.57 million** in annual capacity cost Quality metrics reporting that merely aggregates historical response times and generic state‑wide ramping percentages, without drill‑downs by contract, facility, priority and crew, does not reveal where this avoidable loss occurs. As a result, contractual performance penalties, additional shift coverage, and fleet expansions are used to meet targets instead of systematically reducing bottlenecks. By aligning reporting with modern ambulance clinical indicator frameworks (e.g. ACHS clinical indicators and NSQHS Standards for Ambulance Health Services), services can introduce richer KPIs such as: - Transfer‑of‑care time by hospital and contract - Ambulance clearing time per contract - Percentage of crews ramped >30/60 minutes per shift and use them in contract negotiations and daily operations.[1][4] This improves visibility into capacity loss drivers and supports targeted process changes (e.g. fast‑track triage lanes, ED surge protocols) that reduce ramping and free up crews without major capital investment.

Why This Matters

The Pitch: Ambulance providers in Australia 🇦🇺 waste thousands of crew hours annually on ramping and slow ambulance clearing that are not proactively managed because reporting focuses on narrow or delayed metrics. Automation and expansion of contract quality reporting (e.g. real‑time transfer‑of‑care and clearing time dashboards per contract) can recover 5–10% of operational capacity without extra vehicles.

Affected Stakeholders

Ambulance service CEOs and executives, Contract managers with state health departments, Operations managers and control centre managers, Hospital ED directors and bed managers, Ambulance finance and performance reporting teams

Related Business Risks