The models of care used by DHBs around the country will vary depending on a range of factors, including local workforce, community services, population health and environmental factors.
Although each model of care will have its own measures of success, there are two key measures that are monitored to gain an overall sense of how well the acute care system is performing. These two measures are the:
- Health System Indicator of acute hospital bed days
- 6 hour target of shorter stays in emergency departments (SSED).
Changes in these two measures help identify whether any changes within the system have been effective. A range of other health indicators can build on these measures to give a wider view of acute care performance. These include performance in planned care, timely triaging of patients, patient experience, access to services (including cancer services) and other quality and safety metrics.
Health System Indicator: Acute hospital bed days
The Health System Indicator of acute hospital bed days establishes the use of acute services per person in secondary care that could be improved by:
- effective management in primary care
- transition between the community and hospital settings
- discharge planning
- community support services
- good communication between health care providers.
The indicator is used to manage the demand for acute inpatient services on the health system. Its purpose is to reflect the level of integration between community, primary and secondary care services and to enable making the best use of health resources for planned care rather than acute care.
Information about performance against the acute hospital bed days Health System Indicator is available on the Health Quality & Safety Commission website.
Shorter stays in emergency departments (6 hour target)
To meet the target of shorter stays in emergency departments, an emergency department must admit, discharge or transfer 95 percent of patients within six hours. Long stays in emergency departments are linked to overcrowding, which is associated with delays to care, longer hospital stays, decreased satisfaction, adverse outcomes and, most significantly, increased mortality. The underlying causes of emergency department overcrowding span the whole health system. One cause is access block – that is, an inability to admit emergency department patients to inpatient wards.
Information on performance against the 6 hour target is available at How is my DHB performing?