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Non-admitted patient emergency department service episode—clinical care commencement time, hhmm

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termEmergency department clinical care commencement time
METeOR identifier:Help on this term621847
Registration status:Help on this termHealth, Standard 19/11/2015
ACT Health, Final 08/08/2018
Definition:Help on this termThe time at which emergency department non-admitted clinical care commences, expressed as hhmm.
Context:Help on this termEmergency department care.
Data Element Concept:Non-admitted patient emergency department service episode—clinical care commencement time

Value domain attributes

Representational attributes

Representation class:Help on this termTime
Data type:Help on this termDate/Time
Format:Help on this termhhmm
Maximum character length:Help on this term4

Source and reference attributes

Reference documents:Help on this termISO 8601:2000 : Data elements and interchange formats - Information interchange - Representation of dates and times

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

Emergency department non-admitted clinical care can be commenced by a doctor, nurse, mental health practitioner or other health professional, when investigation, care and/or treatment is provided in accordance with an established clinical pathway defined by the emergency department. Placement of a patient in a cubicle and observations taken to monitor a patient pending a clinical decision regarding commencement of a clinical pathway, do not constitute commencement.

Patients with an episode end status of 'Did not wait to be attended by a healthcare professional' or 'Registered, advised of another health care service, and left the emergency department without being attended by a health care professional' should not have a clinical care commencement time, because they left before investigation, care and/or treatment was commenced by a health professional in accordance with an established clinical pathway defined by the emergency department.

The following examples illustrate the commencement of emergency department non-admitted clinical care.

Example 1

  • A patient presents at the emergency department with mild asthma. At triage, the patient is categorised as category three and returns to the waiting area.
  • The patient has a more severe asthma attack in the waiting area, is re-triaged to category two and shown to a cubicle where standard observations are taken.
  • A nurse comes to the cubicle and commences treatment based on an acknowledged clinical pathway of the emergency department. At this point: emergency department clinical care has commenced.

Example 2

  • A patient presents at the emergency department in an agitated, delusional state. At triage, the patient is categorised as category two and placed in a cubicle and the mental health practitioner notified.
  • Observations are taken and nursing staff continue to observe the patient.
  • The mental health practitioner arrives, assesses the patient and develops a management plan. At this point: emergency department clinical care has commenced.

Example 3

  • A patient presents at the emergency department with an ankle injury from football. At triage, the patient is categorised as category four and moved to the 'fast track area'.
  • The physiotherapist attends, examines the patient, makes an assessment (including diagnostic imaging requirements) and determines a treatment plan. At this point: emergency department clinical care has commenced.

Example 4

  • A patient presents at the emergency department with a sore arm, following a fall, with limited arm movement possible.
  • The patient is categorised as category three at triage and placed in a cubicle.
  • A nurse provides analgesia and assesses the patient, including ordering diagnostic imaging. At this point: emergency department clinical care has commenced.

Example 5

  • A patient presents at the emergency department feeling vague and having been generally unwell for a day or two. The patient has a slight cough. At triage, the patient is categorised as category three.
  • The patient is placed in a cubicle where standard observations are taken. Respiration is 26 bpm, BP is 90/60 and the patient is hypoxic. The patient is given oxygen, and the treating clinician attends and provides instruction regarding patient care. At this point: emergency department clinical care has commenced.

Example 6

  • A patient presents at the emergency department with chest pain. Triage category two is allocated. The patient is placed in a cubicle and a nurse gives oxygen and Anginine, takes blood samples and conducts an ECG. The ECG is reviewed. At this point: emergency department clinical care has commenced.
  • A doctor subsequently arrives and the patient is transferred to the catheter lab after examination.

Example 7

  • The emergency department is notified by ambulance that a patient is being transported having severe behavioural problems.
  • The patient is taken to an appropriate cubicle and restrained.
  • A clinician administers sedation and requests the attendance of a mental health practitioner. At this point: emergency department clinical care has commenced.
Collection methods:Help on this termCollected in conjunction with emergency department clinical care commencement date.

Source and reference attributes

Submitting organisation:Help on this termAustralian Institute of Health and Welfare

Relational attributes

Related metadata references:Help on this term

Has been superseded by Non-admitted patient emergency department service episode—clinical care commencement time, hhmm Health, Standardisation pending 04/10/2018, Independent Hospital Pricing Authority, Proposed 20/09/2018

Supersedes Non-admitted patient emergency department service episode—clinical care commencement time, hhmm Health, Superseded 19/11/2015, Tasmanian Health, Final 02/07/2014, Independent Hospital Pricing Authority, Standard 01/11/2012

Implementation in Data Set Specifications:Help on this term
All attributes +

Non-admitted patient emergency department care NBEDS 2017-18 Health, Standard 05/10/2016

DSS specific attributes +

Non-admitted patient emergency department care NBEDS 2018-19 Health, Standardisation pending 28/09/2017

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2016-17 Health, Superseded 05/10/2016
Independent Hospital Pricing Authority, Proposed 08/09/2015

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2017-18 Health, Standard 05/10/2016

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2018-19 Health, Standardisation pending 18/10/2017
ACT Health, Final 08/08/2018

DSS specific attributes +
Implementation in Indicators:Help on this termUsed as numerator
National Healthcare Agreement: PI 21b–Waiting times for emergency hospital care: proportion of patients whose length of emergency department stay is less than or equal to four hours, 2018 Health, Standard 30/01/2018
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