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Whole-of-hospital response to admission access block: the need for a clinical revolution

David Mountain, Daniel M Fatovich, Drew B Richardson and Sally M McCarthy
Med J Aust 2010; 192 (6): . || doi: 10.5694/j.1326-5377.2010.tb03541.x
Published online: 15 March 2010

To the Editor: Walters and Dawson1 correctly highlight access block (hospital overcrowding) as a whole-of-system problem. Acute medical assessment and admission units (AMAAUs), or other similar incarnations in Australia and New Zealand, are part of the solution, although the evidence presented is low-level non-Australasian data. The reduced length of stay achieved by these units and reported in papers cited by Walters and Dawson would, if replicated in Australasia, produce additional capacity, improving bed availability and patient flow. As has been repeatedly stated: it’s all about available beds!2


  • 1 Australasian College for Emergency Medicine, Melbourne, VIC.
  • 2 Centre for Clinical Research in Emergency Medicine, University of Western Australia, Perth, WA.
  • 3 NRMA–ACT Road Safety Trust Chair of Road Trauma and Emergency Medicine, Australian National University, Canberra, ACT.



  • 1. Walters EH, Dawson DJ. Whole-of-hospital response to admission access block: the need for a clinical revolution. Med J Aust 2009; 191: 561-563. <MJA full text>
  • 2. Fatovich DM, Hughes G, McCarthy SM. Access block: it’s all about available beds. Med J Aust 2009; 190: 362-363. <MJA full text>

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