Offload zone patient selection criteria to reduce ambulance offload delay

Corine M. Laan, Peter T. Vanberkel*, Richard J. Boucherie, Alix J.E. Carter

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
61 Downloads (Pure)


Emergency department overcrowding is a widespread problem and often leads to ambulance offload delay. If no bed is available when a patient arrives, the patient has to wait with the ambulance crew. A recent Canadian innovation is the offload zone—an area where multiple patients can wait with a single paramedic–nurse team allowing, the ambulance crew to return to service immediately. Although a reduction in offload delay was anticipated, it was observed that the offload zone is often at capacity. In this study we investigate why this is the case and use a continuous time Markov chain to evaluate how interventions can prevent congestion in the offload zone. Specifically we demonstrate conditions where the offload zone worsens offload delay and conditions where the offload zone can essentially eliminate offload delay.
Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalOperations research for health care
Issue numberDecember 2016
Publication statusPublished - Dec 2016


  • Offload delay
  • Offload zone
  • Emergency medical services
  • Continuous time Markov chain
  • 2023 OA procedure


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