Overview
Initiative type
Service Improvement
Status
Deliver
Published
27 June 2017
Summary
CLEAR uses a suite of indicators including quality and safety targets to measure Emergency Department (ED) performance against the four-hour emergency access target.
Key dates
Jul 2016 - Jul 2017
Implementation sites
Queensland Hospital Emergency Departments
Aim
Develop changes to the way emergency department (ED) performance is measured in Queensland.
Outcomes
The relationship between the risk-adjusted mortality of inpatients admitted acutely from EDs (the emergency hospital standardised mortality ratio [eHSMR]: the ratio of the numbers of observed to expected deaths) and NEAT compliance rates for all presenting patients (total NEAT) and admitted patients (admitted NEAT).
These findings from the Healthcare Improvement Unit-led CLEAR project paved the way for improved measurements of ED performance.
Background
Retrospective observational study of all de-identified episodes of care involving patients who presented acutely to the EDs of 59 Australian hospitals between 1 July 2010 and 30 June 2014.
Methods
Queensland’s public hospitals now report emergency access times against this new target. The CLEAR paper was published in the Medical Journal of Australia on 16 May 2016 as The National Emergency Access Target (NEAT) and the 4-hour rule: time to review the target.
Discussion and results
Analysis of 12.5 million ED episodes of care identified that an emergency access target of between 80 to 85 percent provided the best outcomes when a person was admitted to hospital. Based on the CLEAR research, Queensland set a Queensland Emergency Access Target (QEAT) of greater than 80 percent.