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Hospital Performance: Time patients spent in emergency departments 2011–12
Role of the National Health Performance Authority
The National Health Performance Authority has been set up as an independent agency under the National Health Reform Act 2011. It commenced full operations in 2012.
Under the terms of the Act, the Authority will monitor and report on the performance of Local Hospital Networks, public and private hospitals, primary health care organisations and other bodies that provide healthcare services.
The Authority will base its activities on a set of nearly 50 performance indicators agreed to by the Council of Australian Governments (COAG). Some apply to hospitals, while others are relevant for primary healthcare providers. They include measures of safety and quality, access and efficiency, and financial performance.
In this, its first report, the Authority has chosen to focus on a subset of the indicators that relate to the performance of public hospitals and their emergency departments (EDs), and has developed a new method of grouping hospitals, to ensure that comparisons are fair between them.
Specifically, the report examines the extent to which patients are leaving EDs within the timeframe set out in the National Emergency Access Target adopted by COAG. The target varies by state and territory, rising progressively until 2015, when it becomes a uniform national target for 90% of all patients to leave EDs within four hours.
The report includes data that identifies the 10% of hospitals with the highest percentages of patients who leave ED within four hours, as well as the 10% with the lowest percentages.
However, in this report the Authority makes no determination that any particular hospital is performing either poorly or well. Hospitals have a full two years to reach the 2015 target, and a number are already meeting it.
Hospital Performance: Time patients spent in emergency departments in 2011–12, is based on data from 122 major, large and medium-sized hospitals. A further 12 specialist hospitals contributed data but are not considered comparable.
- In 2011–12 the percentage of all patients departing ED within four hours ranged from 74% to 33% among major metropolitan hospitals, and from 79% to 47% among major regional hospitals.
- Among large metropolitan hospitals, the range was from 83% to 48%, and from 92% to 61% among large regional hospitals.
- The range among medium hospitals was from 93% to 41%.
- The percentage of patients departing ED within four hours was lowest among subsequently admitted patients and highest among non-admitted patients.
- The percentage of admitted patients at major metropolitan hospitals departing ED within four hours ranged from 55% to 9%, while for discharged patients the range was from 91% to 45%.
- The length of time within which 90% of admitted patients departed ED ranged nationally from 5 hours and 28 minutes to 27 hours and 59 minutes. The remaining 10% of admitted patients took longer than this time. There is no national target for this measure.
The Authority assumed responsibility for MyHospitals in July 2012. In this report we release 2011–12 data for more than 400 hospitals covering:
- Waiting times for elective surgery.
- Waiting times for treatment in an ED.
- Time spent in ED from arrival to departure.
- Presentations to ED.
- Hand hygiene rates.
In 2011 the National Emergency Access Target (NEAT) was established under the National Partnership Agreement on Improving Public Hospital Services between Commonwealth, State and Territory governments. Between 2012 and 2015, each state and territory has a different target for the percentage of ED patients expected to depart ED within four hours.
In 2012, the target ranges from 76% in Western Australia to 64% in the Australian Capital Territory. These targets increase progressively until 2015, when it reaches 90% for each State and Territory.
In this first report, the Authority has grouped hospitals and provided data for patient types so meaningful comparisons can be made. This helps identify successful hospitals from which others may learn, as well as others that may require extra help to meet the targets. Typically, hospitals may perform well in one area and have room for improvement in another.
It is therefore not the intention of the Authority to create hospital rankings, as such methods tend to focus on single performance indicators and ignore the wider picture.