Ambulance arriving at RAH in Adelaide, South Australia

Demand Escalation Framework

The Demand Escalation Framework (DEF) helps manage patient flow in times of high demand through four escalation levels.

Processes for each specialty area provide clarity and accountability for ward staff, medical teams and patient flow coordinators.


Escalation levels

There are four escalation levels:

  • Level 0 – Business-as-usual (green)
  • Level 1 – Moderate compromise (yellow)
  • Level 2 – Severe Compromise (red)
  • Level 3 – Extreme compromise (white)

Each level is triggered by certain criteria and allows the network to better respond during times of sustained high demand.

Escalation levels are decided and communicated by the Network Operations Centre (NOC).

For criteria, see Hospital triggers (PDF 113KB).

The framework also ensures timely de-escalation so that all staff know when normal business-as-usual functions have resumed.

View the demand escalation framework (PDF 432KB).


Task cards

Once the escalation level has been decided, each specialty area needs to follow the process in their task card (a formalised risk matrix).

Task cards define the roles and responsibilities of staff across the four escalation levels.

Cards were created in consultation with nurse leads and program delivery managers.


Specialty area task cards

Escalation definitionsThe escalation levels ensure our network is working in tandem with other Local Health Networks who are using the same framework and escalation definitions.

For details, see Department of Health and Wellbeing escalation definitions (PDF 34KB).


Notification and Escalation Process

Escalation will be initiated by the Patient Flow and Demand Manager in the first instance.

For details, see Notification and Escalation Process (PDF 121KB)


Contact and more information

For help with the DEF, email

See more about the Network Operation Centre on the CALHN intranet.

Central Adelaide LHN acknowledges the Kaurna people as the traditional owners of the lands on which its sites are located. We respect their spiritual relationship with their country and that their cultural and heritage beliefs are still as important to living Aboriginal and Torres Strait Islander people today.



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