002 Managing Surge and Flow across aged care and Hospitals

Ambulance ramping and hospital exit block are commonly framed as emergency department problems, but residential aged care sits on both sides of the pressure. Aged care influences who is transferred to hospital and who can be safely discharged back. Australian evidence shows high transfer rates, a substantial "grey zone" of potentially avoidable transfers, and hundreds of thousands of patient days lost to people awaiting aged care or disability placement. Service models bringing clinical capability into facilities can improve decision-making, though fewer transfers is not automatically better. The Aged Care Act 2024 and workforce requirements shape, but do not directly resolve, this interface. Boards should treat it as an assurance question.