Clearing emergency departments and clogging wards: National Emergency Access Target and the law of unintended consequences

Abstract

At the current institution NEAT success has been guarded, likely secondary to availability of inpatient beds. The implementation of NEAT appears to have reduced emergency waiting times. These early results suggest concurrent a detrimental effect on IPLOS; however, some of this effect may be a result of a large increase in short stay admissions.

Improving emergency department transfer for patients arriving by ambulance: A retrospective observational study

“…During the study time period, 34% of patients arriving to the ED by ambulance met NEAT and 60% had a POST of <30 min. Difficulties reaching the NEAT are not unique to our study, with other studies (not limited to those arriving by ambulance) from 2012 reporting NEAT figures of 53%–54% . Limited research exists regarding POST making comparison with our findings difficult.…”

The ‘four‐hour target’ and the impact on Australian metropolitan acute surgical services

“…Unfortunately, the literature surrounding the focal effects of ED occupancy on acute surgical services is sparse. 19 The time delay between surgical admission and ED separation reduced during the study period reflected in a modest reduction of EDLOS. 20 Further studies have postulated that ED overcrowding may be associated with the inappropriate treatment of patients in non-treatment areas (such as patients located on trolleys or in corridors).…”

Two Hour Evaluation and Referral Model for Shorter Turnaround Times in the emergency department

“…This was achieved at the additional cost of approximately two ward admissions per day and two internal transfers per week, without evidence of inappropriate discharge or risk of clinical deterioration on the wards. These results would suggest that improved consultant oversight did help to minimise the impact of early referral on inpatient units, despite the difficulties reported by other health services …”