CODE RED:
Perth’s Health System in Crisis
Emergency Department Dysfunction, Ambulance Ramping & the Case for AI-Driven Process Reform
Executive Summary
Western Australia is facing a healthcare emergency. Perth’s public hospital network, servicing a fastgrowing metropolitan population of approximately 2.3 million people, is under extraordinary pressure. Emergency Departments (EDs) across the city’s major public hospitals – including Royal Perth Hospital, Fiona Stanley Hospital, Sir Charles Gairdner Hospital and Joondalup Health Campus – are operating at or beyond capacity on a daily basis.
The crisis is systemic and multifaceted. Patients who call 000 for an ambulance face extended response delays because St John Ambulance crews are trapped at hospital ramps, unable to offload patients into overcrowded EDs – a phenomenon known as ambulance ramping. Once inside the ED, patients endure waits of three to six hours before seeing a doctor. Behind these visible symptoms lies a deeper structural failure: outdated digital infrastructure, fragmented data systems, manual and paper-based processes, and an absence of intelligent, data-driven resource management.
Population projections indicate that the Perth metropolitan area will grow to 3.1 million residents by 2040, intensifying every dimension of this crisis. Without fundamental transformation of healthcare processes and digital capability, patient outcomes will deteriorate further, clinical staff will continue to leave the profession due to burnout, and the system will reach a breaking point.
This case study presents a real-world Business Process Management challenge: analyse the current state of Perth’s emergency healthcare system, model its dysfunctional processes, and design two alternative future-state process models that harness the power of Artificial Intelligence, automation and digital integration to eliminate waste, reduce delays and improve patient outcomes.
Learning Objectives
Upon completing this case study, students will be able to:
1. Analyse a complex, multi-stakeholder public sector process environment and identify sources of waste, delay and failure using BPM frameworks including BPMN 2.0.
2. Construct an accurate As-Is process model of the Perth emergency healthcare system, documenting swim lanes for multiple organisational actors across the end-to-end patient journey. 3. Apply value-stream mapping principles to distinguish value-adding from non-value-adding activities in a health context.
4. Design two distinct To-Be process improvement scenarios (Option A: Incremental AIAugmented; Option B: Transformational AI-Native) and represent these in BPMN 2.0 notation.
5. Evaluate the trade-offs, risks, implementation challenges and stakeholder implications of each improvement option.
6. Develop an executive briefing for senior NHS leadership in a concise, evidence-based format with your recommendations and justifications
DELIVERABLES
Deliverable 1: As-Is Process Model
Deliverable 2: To-Be Option A
Deliverable 3: To-Be Option B and Executive briefing
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