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:474116
Registration status:Health, Superseded 19/11/2015
Tasmanian Health, Archived 27/05/2020
Independent Hospital Pricing Authority, Standard 01/11/2012
Definition:The date on which emergency department non-admitted clinical care commences, expressed as DDMMYYYY.
Context:Emergency department care.

Data element concept attributes

Identifying and definitional attributes

Data element concept:Non-admitted patient emergency department service episode—clinical care commencement date
METeOR identifier:474126
Registration status:Health, Standard 30/01/2012
Tasmanian Health, Endorsed 27/05/2020
Independent Hospital Pricing Authority, Standard 01/11/2012
ACT Health, Final 19/07/2018
Definition:The date on which non-admitted patient emergency department clinical care commences.
Context:Emergency department care.
Object class:Non-admitted patient emergency department service episode
Property:Clinical care commencement date

Value domain attributes

Identifying and definitional attributes

Value domain:Date DDMMYYYY
METeOR identifier:270566
Registration status:Housing assistance, Standard 01/03/2005
Health, Standard 01/03/2005
Early Childhood, Standard 21/05/2010
Homelessness, Standard 23/08/2010
Tasmanian Health, Endorsed 31/08/2016
WA Health, Endorsed 06/03/2014
Independent Hospital Pricing Authority, Standard 31/10/2012
Indigenous, Endorsed 11/08/2014
Commonwealth Department of Health, Standard 14/10/2015
Disability, Standard 07/10/2014
Children and Families, Standard 22/11/2016
Community Services (retired), Standard 01/03/2005
National Health Performance Authority (retired), Retired 01/07/2016
ACT Health, Final 19/07/2018
Commonwealth Department of Social Services (retired), Not progressed 15/04/2019
Definition:The day of a particular month and year.

Representational attributes

Representation class:Date
Data type:Date/Time
Format:DDMMYYYY
Maximum character length:8

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' 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, 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:Collected in conjunction with emergency department clinical care commencement time.

Source and reference attributes

Submitting organisation:Australian Government Department of Health and Ageing

Relational attributes

Related metadata references:

Has been superseded by Non-admitted patient emergency department service episode—clinical care commencement date, DDMMYYYY Health, Superseded 05/10/2016

Supersedes Non-admitted patient emergency department service episode—clinical care commencement date, DDMMYYYY Health, Superseded 30/01/2012

Supersedes Non-admitted patient emergency department service episode—service commencement date, DDMMYYYY Health, Superseded 30/01/2012, Tasmanian Health, Draft 24/03/2014

Implementation in Data Set Specifications:
All attributes +

Activity based funding: Emergency department care DSS 2013-2014 Independent Hospital Pricing Authority, Superseded 01/03/2013

DSS specific attributes +

Emergency department care activity based funding DSS 2012-2013 Independent Hospital Pricing Authority, Superseded 31/10/2012

DSS specific attributes +

Non-admitted patient emergency department care DSS 2014-15 Health, Superseded 04/02/2015

DSS specific attributes +

Non-admitted patient emergency department care DSS 2015-16 Health, Superseded 02/12/2015

DSS specific attributes +

Non-admitted patient emergency department care NBEDS 2016-17 Health, Superseded 05/10/2016

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2012-13 Health, Superseded 07/02/2013

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2013-14 Health, Superseded 11/04/2014

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2014-15 Health, Superseded 13/11/2014

DSS specific attributes +

Non-admitted patient emergency department care NMDS 2015-16 Health, Superseded 19/11/2015

DSS specific attributes +
Implementation in Indicators:Used as numerator
National Healthcare Agreement: PI 21b-Waiting times for emergency hospital care: Proportion completed within four hours, 2015 Health, Superseded 08/07/2016
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, 2016 Health, Superseded 04/08/2016
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, 2017 Health, Superseded 30/01/2018