Data collection and reporting

Data collection is important in emergency departments (EDs) to:

• inform service planning and monitoring
• identify safety and quality trends
• funding associated with the provision of emergency care.

Various data points are collected through the patient’s journey.

Emergency department performance

Providing timely access to emergency care improves the experience and outcomes for patients and carers. In NSW, these measures are part of the NSW performance framework and the Future Health strategy.

Emergency treatment performance

Emergency treatment performance (ETP) is a key performance indicator in the service level agreement between the Ministry of Health and local health districts and speciality health networks.

ETP is measured from first patient contact in the ED. It should be recorded by the clinician carrying out the initial triage or assessment or by ED reception, whichever is earlier. The clock stops when the patient physically leaves the ED, whether they are admitted, transferred or discharged home.

Triage should occur as soon as possible after a patient presents to an emergency department, but where clerical staff contact comes first this is when the clock starts.

The emergency treatment performance (ETP) target is that 81% of all patients presenting to a public hospital emergency department (ED) will, within four hours:

• physically leave the ED for admission to hospital
• be referred to another hospital for treatment, or
• be discharged home.

The key performance indicator for admitted patients is for 50% of admitted patients physically leave the ED for admission to hospital within 4 hours. It is acknowledged that often patients need to stay in the ED for clinical reasons, Hence the need to meet performance measures does not overrule clinical judgement regarding transfer out of the ED.

Transfer of care

Transfer of care is the transfer of accountability and responsibility for a patient from an ambulance paramedic to an emergency department clinician. Transfer of care is deemed complete when clinical handover has occurred, the patient has been offloaded from the ambulance stretcher and the care of the paramedics is no longer required.

Transfer of care is a tier 1 key performance indicator in the service agreements between the Ministry of Health and all local health districts and specialty health networks. All NSW facilities that have an ED have a target of offloading 90% of patients within 30 minutes.

Time to treatment

The time from patient arrival to time to treatment is based on the Australian Triage Scale timeframes.

Resources

Emergency department data dictionary (PD2009_071)
Details of the data to be collected by emergency departments.
NSW Ministry of Health

NSW emergency department data collection (EDDC) reporting and submission requirements (PD2018_047)
The scope, governance and reporting and submission requirements for data collection in NSW emergency departments.
NSW Ministry of Health

Performance measurement timeline

In NSW the focus of performance measurement followed the international and national experience, evidence and mandates.

• 2000

  National Health Service (NHS) in the United Kingdom inplements four-hour rule target

• 2009

  Western Australia introduces four-hour rule target

• 2012

  Australian government creates National Emergency Access Target (NEAT)

  NSW Health starts Whole of Hospital program

• 2015

  Whole of Hospital becomes Whole of Health program in NSW