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Research - Validation and Impact of the 4 hour rule in ED

Research Project Overview

Validation and Impact of the 4 hour rule in Emergency Departments


In 2008, the Australasian College for Emergency Medicine confirmed and ratified that access block and emergency department (ED) overcrowding were the most serious issues confronting EDs in the developed world because they compromise quality and timeliness of patient care. Since then, there have been significant changes and innovations in and outside the ED. In 2009, the Australian Federal Government announced plans for a Four Hour National Emergency Access Target (NEAT). The Four-Hour NEAT is defined as a target whereby 85% of patients must spend less than four hours in the emergency department (ED) from arrival to admission, transfer or discharge. The NEAT started to be progressively implemented from 1st January 2011 until 2015. In 2012 we obtained a NHMRC Partnership Grant (APP1029492) to study this issue.

We need to understand which policy interventions are most effective in promoting improvement in patient care while reducing the impact of access block and overcrowding on patients. This research project explores the initial impact of the four hour NEAT policy, starting in Western Australia and progressing to New South Wales, the Australian Capital Territory, and Queensland. This is the first systematic assessment of a large scale health policy implementation and its impact on patient and clinical outcomes in Australia.

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