Shorter Stays in Emergency Departments health target
Since 1 July 2009 there has been a Health Target focused on emergency departments (EDs) and improving acute patient flow.
What is the target?
The target is called Shorter Stays in Emergency Departments, and is defined as ‘95 percent of patients will be admitted, discharged or transferred from an Emergency Department within six hours’.
The target considers the patient's whole length of stay in the ED and aims to eliminate waits and delays in all parts of the hospital to improve acute patient flow.
Why is the target important?
Emergency department (ED) length of stay is an important measure of the quality of acute (emergency and urgent) care in our public hospitals, because:
- EDs are designed to provide urgent (acute) health care; the timeliness of treatment delivery (and any time spent waiting) is by definition important for patients
- long stays in EDs are linked to overcrowding
- medical and nursing literature has linked both long stays and overcrowding in EDs to negative clinical outcomes for patients such as increased mortality and longer inpatient lengths of stay
- overcrowding can also lead to compromised standards of privacy and dignity for patients, for instance, through the use of corridor trolleys to house patients.
Why a target of 95 percent within 6 hours?
The target was devised by clinicians who thought it represented the right amount of time, for the right proportion of patients, to deliver good quality care.
Both the Australasian College for Emergency Medicine (ACEM) and the College of Emergency Nurses New Zealand (CENNZ) agree six hours is a reasonable amount of time in which to treat and admit patients. That is, long enough for good clinical care, but not unjustifiably long.
This was also the target measure recommended in the report from the Working Group for Achieving Quality in Emergency Departments (2008).
How will the target be achieved?
The target is not an end in itself, but a means to an end – a means to focus and prioritise the activities of District Health Boards (DHBs) so that the quality of acute care is improved. Improving the quality of acute services requires a ‘whole of system’ response. All DHBs are committed to achieving the target and have a programme of activities in place to improve performance. Information on a range of tools, resources and case studies relating to the target can be found online at the Health Improvement and Innovation Resource Centre.
Targeting Emergencies: Shorter Stays in Emergency Departments profiles the approach and activities in a range of DHBs to achieve the Shorter Stays in ED Health Target.
Related areas
Page last updated: 28 June 2011
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