Non-admitted patient emergency department service episode—clinical care commencement date, DDMMYYYY

Identifying and definitional attributes
Metadata item type:	Data Element
Short name:	Emergency department clinical care commencement date
METEOR identifier:	652390
Registration status:	Health, Superseded 20/10/2021 Tasmanian Health, Superseded 22/03/2023
Definition:	The date on which non-admitted patient emergency department clinical care commences, expressed as DDMMYYYY.
Context:	Emergency department care.
Data Element Concept:	Non-admitted patient emergency department service episode—clinical care commencement date
Value Domain:	Date DDMMYYYY

Value domain attributes
Representational attributes
Representation class:	Date
Data type:	Date/Time
Format:	DDMMYYYY
Maximum character length:	8

Source and reference attributes
Submitting organisation:	Australian Institute of Health and Welfare

Data element attributes
Collection and usage attributes
Guide for use:	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 date, 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, blood pressure 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 electrocardiogram (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:	Collected in conjunction with emergency department clinical care commencement time.
Source and reference attributes
Submitting organisation:	Australian Institute of Health and Welfare
Relational attributes
Related metadata references:	Supersedes Non-admitted patient emergency department service episode—clinical care commencement date, DDMMYYYY Health, Superseded 05/10/2016 Has been superseded by Non-admitted patient emergency department service episode—clinical care commencement date, DDMMYYYY Health, Standard 20/10/2021 Tasmanian Health, Standard 22/03/2023
Implementation in Data Set Specifications: All attributes +	Emergency department presentation related data elements (TDLU) cluster Tasmanian Health, Superseded 13/11/2023 Non-admitted patient emergency department care NBEDS 2017-18 Health, Superseded 12/12/2018 DSS specific attributes + Implementation start date: 01/07/2017 Implementation end date: 30/06/2018 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department as a non-admitted patient; Code 7 - Dead on arrival, emergency department clinician certified the death of the patient. Non-admitted patient emergency department care NBEDS 2018-19 Health, Superseded 12/12/2018 DSS specific attributes + Implementation start date: 01/07/2018 Implementation end date: 30/06/2019 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department as a non-admitted patient; Code 7 - Dead on arrival, emergency department clinician certified the death of the patient. Non-admitted patient emergency department care NBEDS 2019–20 Health, Retired 19/11/2019 DSS specific attributes + Implementation start date: 01/07/2019 Implementation end date: 30/06/2020 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department as a non-admitted patient; Code 7 - Dead on arrival, emergency department clinician certified the death of the patient. Non-admitted patient emergency department care NMDS 2017-18 Health, Superseded 25/01/2018 DSS specific attributes + Implementation start date: 01/07/2017 Implementation end date: 30/06/2018 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department as a non-admitted patient; Code 7 - Dead on arrival, emergency department clinician certified the death of the patient. Non-admitted patient emergency department care NMDS 2018-19 Health, Superseded 12/12/2018 DSS specific attributes + Implementation start date: 01/07/2018 Implementation end date: 30/06/2019 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department as a non-admitted patient; Code 7 - Dead on arrival, emergency department clinician certified the death of the patient. Non-admitted patient emergency department care NMDS 2019–20 Health, Superseded 18/12/2019 DSS specific attributes + Implementation start date: 01/07/2019 Implementation end date: 30/06/2020 Conditional obligation: This data item is to be recorded if the patient has one of the following Episode end status values recorded: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department. Non-admitted patient emergency department care NMDS 2020–21 Health, Superseded 05/02/2021 DSS specific attributes + Implementation start date: 01/07/2020 Implementation end date: 30/06/2021 Conditional obligation: This data item is only required to be reported if the value for Non-admitted patient emergency department service episode—episode end status, code Nis recorded as: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department. Non-admitted patient emergency department care NMDS 2021–22 Health, Superseded 20/10/2021 DSS specific attributes + Implementation start date: 01/07/2021 Implementation end date: 30/06/2022 Conditional obligation: This data item is only required to be reported if the value for Non-admitted patient emergency department service episode—episode end status, code Nis recorded as: Code 1 - Admitted to this hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward); Code 2 - Non-admitted patient emergency department service episode completed - departed without being admitted or referred to another hospital; Code 3 - Non-admitted patient emergency department service episode completed - referred to another hospital for admission; Code 5 - Left at own risk after being attended by a health care professional but before the non-admitted patient emergency department service episode was completed; Code 6 - Died in emergency department. Tasmanian Emergency Department Data Set - 2020 Tasmanian Health, Superseded 22/11/2023 DSS specific attributes + Implementation start date: 01/07/2020 Implementation end date: 30/06/2021 Tasmanian Emergency Department Data Set - 2021 Tasmanian Health, Superseded 22/11/2023 DSS specific attributes + Implementation start date: 01/07/2021 Implementation end date: 30/06/2022 Conditional obligation: Required if episode of care meets the data elements criteria Tasmanian Emergency Department Data Set - 2022 Tasmanian Health, Superseded 22/11/2023 DSS specific attributes + Implementation start date: 01/07/2022 Implementation end date: 30/06/2023 Conditional obligation: If applicable
Implementation in Indicators:	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, 2019 Health, Superseded 13/03/2020 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, 2019 Health, Superseded 13/03/2020