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Service Agreement - Department of Health and Human Services Tasmania: 2014, Percentage of patients with transfer of care completed within 15 and 30 minutes, 2014

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termAmbulance offload delay (percentage)
Synonymous names:Help on this termAmbulance offload delay
METeOR identifier:Help on this term493696
Registration status:Help on this termTasmanian Health, Archived 09/12/2016
Description:Help on this term

This KPI measures the percentage of Ambulance Tasmania presentations to an emergency department for which transfer of clinical care to the emergency department occurs within the Australasian College for Emergency Medicine recommended target times.

Rationale:Help on this term

Timely transfer of ambulance patients into hospital emergency departments is an important access issue. Ambulance offload delay is often symptomatic of the wider health system’s failure to effectively manage demand. The Australasian College for Emergency Medicine released a Position Statement on Ambulance Ramping in November 2013, which recommends that in a well-functioning system, the interval between ambulance arrival and clinical handover should routinely occur within 15 minutes and never more than 30 minutes.

This indicator indirectly measures the incidence of Ambulance Offload Delay (AOD) at 15 minutes and 30 minutes from presentation time.

Indicator set:Help on this termService Agreement - Department of Health and Human Services Tasmania: 2014 Tasmanian Health, Archived 12/12/2016
Outcome area:Help on this termEmergency Department access Tasmanian Health, Endorsed 07/12/2016

Collection and usage attributes

Computation:Help on this term

The definitions applied were recommended by the Australasian College for Emergency Medicine. The definitions include presentations that have been assigned a triage category between 1 and 5.  Presentations that are 'dead on arrival' are excluded for the purpose of calculating this indicator. The definition includes presentations that arrive by Ambulance Tasmania (arrival modes such as police, non-emergency patient transport are out of scope).


Ambulance offload delay is calculated for Ambulance Tasmania presentations by subtracting the presentation date and time from the date and time the patient was transferred to the care of the emergency department.

 
Transfer of care is deemed to have occurred when the patient:

  • Has physically moved from Ambulance Tasmania care to a physical space in the ED
  • Is for immediate discharge from the ED after initial assessment
  • Leaves the ED with the ambulance service for a clinically appropriate transfer to another clinical service; or
  • Discharges themselves.

See Position Statement on Ambulance Ramping (S347) from the Australasian College for Emergency Medicine for key definitions for data collection.


The indicator is presented as a percentage.

Numerator:Help on this term

Total number of presentations to public hospital emergency departments with arrival mode of Ambulance Tasmania minus those not transferred to ED staff care within the following benchmarks:

  • 85% of presentations to be transferred within 15 minutes
  • 100% of presentations to be transferred within 30 minutes
Numerator data elements:Help on this term
Data Element / Data SetEmergency department stay—ambulance offload delay, total minutes NNNNN
Guide for use

Data is obtained from the following data fields in Health Central: 

Calculated by subtracting the date and time the patient has been transferred to the care of emergency department staff minus the date and time of patient arrival when greater than 15 or 30 minutes.

Computation methods:

 ([StaySegmentEndDateTime] - [ArrivalDateTime]) when > than 15 or 30 minutes* and the [LocationDescription] field is Ambulance waiting.


Data Element / Data SetEmergency department stay—service delivery location, text X[X(49)]
Guide for use

Data is obtained from the [LocationDescription] field in Health Central where the location is recorded as Ambulance waiting


Data Element / Data SetEpisode of care—episode identifier, N[NNNNNN]
Guide for use
Data is obtained from the [EmergencyIdentifier] field in Health Central.

Data Element / Data SetEstablishment—organisation identifier, (Tasmanian) identifier NNNN
Data Element / Data SetEmergency department stay—transport mode (arrival), Tasmanian code N[N]
Guide for use
Data is obtained from the [ArrivalModeRefId] field in Health Central where the arrival mode is recorded as Tasmanian Ambulance.
Data Element / Data SetNon-admitted patient emergency department service episode—triage category, (Tasmanian) code N
Guide for use

Data is obtained from the [TriageCategoryRefId] field in Health Central and includes records with the triage categories from 1 to 5.


Data Element / Data SetEmergency department stay—physical departure date, DDMMYYYY
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.
Data Element / Data SetEmergency department stay—physical departure time, hhmm
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.
Denominator:Help on this termTotal number of ambulance presentations with the arrival mode of Ambulance Tasmania 
Denominator data elements:Help on this term
Data Element / Data SetEmergency department stay—transport mode (arrival), Tasmanian code N[N]
Guide for use
Data is obtained from the [ArrivalModeRefId] field in Health Central where the arrival mode is recorded as Tasmanian Ambulance.
Data Element / Data SetEstablishment—organisation identifier, (Tasmanian) identifier NNNN
Data Element / Data SetEpisode of care—episode identifier, N[NNNNNN]
Guide for use
Data is obtained from the [EmergencyIdentifier] field in Health Central.
Data Element / Data SetNon-admitted patient emergency department service episode—triage category, (Tasmanian) code N
Guide for use

Data is obtained from the [TriageCategoryRefId] field in Health Central and includes records with the triage categories from 1 to 5.


Data Element / Data SetEmergency department stay—physical arrival date, DDMMYYYY
Guide for use
Data is obtained from the [ArrivalDateTime] field in Health Central.
Data Element / Data SetEmergency department stay—physical arrival time, hhmm
Guide for use
Data is obtained from the [ArrivalDateTime] field in Health Central.
Data Element / Data SetEmergency department stay—physical departure date, DDMMYYYY
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.
Data Element / Data SetEmergency department stay—physical departure time, hhmm
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.
Disaggregation:Help on this termSpecified disaggregation: Hospital, triage category and reporting month based on the date of the end of the emergency department stay
Disaggregation data elements:Help on this term
Data Element / Data SetNon-admitted patient emergency department service episode—triage category, (Tasmanian) code N
Data Element / Data SetEstablishment—organisation identifier, (Tasmanian) identifier NNNN
Data Element / Data SetEmergency department stay—physical departure date, DDMMYYYY
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.
Data Element / Data SetEmergency department stay—physical departure time, hhmm
Guide for use
Data is obtained from the [DepartureDateTime] field in Health Central.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termTime (e.g. days, hours)
Format:Help on this termNN[N]

Accountability attributes

Reporting requirements:Help on this term
  • 2014-15 Service Agreement
My items Help on this term
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