Tuesday, 3 February 2015

The effect of Timely Quality Care in emergency patient attendance at the Alfred Hospital

A study co-authored by SPHPM’s Dr Andrea Curtis, Dr Judy Lowthian, Dr Lahn Straney and Amy McKimm, Martin Keogh and Andrew Stripp from Alfred Health has evaluated the effect of the Timely Quality Care framework on improving patient care through time management and inquiry into admissions, emergency and discharge procedures at the Alfred Hospital.

In 2011, the National Emergency Access Target was implemented to ensure that by 2015, 90% of patients who are admitted to the Emergency Department will be discharged, admitted to a hospital or transferred to another centre within four hours. This was inclusive of all emergency patients and to reduce overcrowding within departments and to minimise delays of ambulance offloads.

The Timely Quality Care framework was utilised in this study to determine its efficacy in meeting the NEAT target. This was measured through a retrospective analysis of emergency department intakes before and after the NEAT implementation (2009-2013). Comparison was between the number of patients admitted, discharged or transferred from the emergency department within four hours as well as those who remained in the emergency department. 

The results indicated that the Timely Quality Care framework has had a positive effect in the timeliness within the emergency department. The proportion of attendees in the emergency department being admitted, transferred or discharged during the four hour period increased from 60% in 2010 (before NEAT) to 74% in 2013 (after NEAT’s introduction). Mortality of patients who were admitted also decreased from 3.5% to 2.2%. These results are indicative of the efficacy of the framework.

The researchers conclude that the Timely Quality Care framework can have a positive impact within the emergency department without affecting or altering safety or quality of care for patients. They correlate this achievement to the engagement with stakeholders and an all-encompassing approach in re-creating the system of care within the Alfred.

Read the study in its entirety here.

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