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National Partnership Agreement on Improving Public Hospital Services: Admission to hospital from emergency departments

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Common name:Help on this termAccess block indicator
Short name:Help on this termAdmission to hospital from emergency departments
METeOR identifier:Help on this term517314
Registration status:Help on this termHealth, Standard 15/06/2012
Description:Help on this term

For all patients presenting to a public hospital emergency department (including publicly funded privately operated hospitals) who are subsequently admitted to the same hospital, the:

(a) percentage of presentations where the time from presentation to physical departure (i.e. the emergency department stay length) is ≤4 hours (i.e. ≤240 minutes); and

(b) emergency department stay length at the 90th percentile.
Indicator set:Help on this termPerformance Indicators for the National Partnership Agreement on Improving Public Hospital Services Health, Standard 21/11/2013

Collection and usage attributes

Computation description:Help on this term

Data are provided as per the Non-admitted patient emergency department care (NAPEDC) NMDS 2012-13.

The scope for calculation of access block measures is all hospitals reporting to the NAPEDC NMDS (Peer Groups A, B and other) as at August 2011, when the National Health Reform Agreement - National Partnership Agreement on Improving Public Hospital Services (NPA IPHS) was signed. For the duration of the NPA IPHS, hospitals that have not previously reported to the NAPEDC NMDS can come into scope, subject to agreement between the jurisdiction and the Commonwealth.

Calculation includes presentations with any Type of visit to emergency department.

Calculation includes presentations with an Episode end status of:

(1) Admitted to hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward)

Emergency department stay (ED stay) length is calculated by subtracting the Date patient presents and Time patient presents from the Emergency department physical departure date and Emergency department physical departure time as per the business rules included in the NAPEDC NMDS 2012-13, as follows:

Presentation date and time are the date and time of the first recorded contact with an emergency department staff member. The first recorded contact can be the commencement of the clerical registration or triage process, whichever happens first.

Physical departure date and time is:

  • For patients subsequently admitted to this hospital (either in a short stay unit, hospital-in-the-home or non-emergency department hospital ward), then record the time the patient leaves the emergency department to go to the admitted patient facility.
    • Patients admitted to any other ward or bed within the emergency department have not physically departed the emergency department until they leave the emergency department.
    • If the patient is admitted and subsequently dies before leaving the emergency department, then record the time the body was removed from the emergency department.
Computation:Help on this term

(a) 100 × (Numerator ÷ Denominator)

(b) ED stay length (in hours and minutes) at the 90th percentile for ED presentations with an Episode end status of 1, i.e. Admitted to hospital (either short stay unit, hospital-in-the-home or non-emergency department hospital ward)
Numerator:Help on this term

(a) Number of ED presentations with an Episode end status of 1, where ED stay length is ≤4 hours (i.e. ≤240 minutes)

(b) Not applicable

Numerator data elements:Help on this term
Data Element / Data SetNon-admitted patient emergency department service episode—episode end status, code N
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Data Element / Data SetEmergency department stay—presentation date, DDMMYYYY
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Data Element / Data SetEmergency department stay—presentation time, hhmm
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Data Element / Data SetEmergency department stay—physical departure date, DDMMYYYY
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Data Element / Data SetEmergency department stay—physical departure time, hhmm
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Denominator:Help on this term

(a) Number of ED presentations with an Episode end status of 1

(b) Not applicable
Denominator data elements:Help on this term
Data Element / Data SetNon-admitted patient emergency department service episode—episode end status, code N
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Disaggregation:Help on this termDisaggregation is by state/territory
Disaggregation data elements:Help on this term
Data Element / Data SetEstablishment—organisation identifier (Australian), NNX[X]NNNNN
Data Source
National Emergency Access Target data
NMDS / DSS
Non-admitted patient emergency department care NMDS 2012-13
Comments:Help on this termThis indicator is not intended to suggest that all patients who are admitted to a hospital from an ED should leave the ED within four hours. As per the Expert Panel Review of Elective Surgery and Emergency Access Targets under the National Partnership Agreement on Improving Public Hospital Services, there may be patients "...for whom it is clinically appropriate to remain in an emergency department longer than four hours" (p30).

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this termNN[N]

Data source attributes

Data sources:Help on this term
Data SourceNational Emergency Access Target data
Frequency
Quarterly
Data custodian
Department of Health and Ageing; Australian Institute of Health and Welfare

Accountability attributes

Reporting requirements:Help on this term

National Partnership Agreement on Improving Public Hospital Services

Organisation responsible for providing data:Help on this termAustralian Institute of Health and Welfare; Department of Health and Ageing

Source and reference attributes

Submitting organisation:Help on this termNational Health Information Standards and Statistics Committee (NHISSC) - Emergency Data Development Working Group
Reference documents:Help on this term

Standing Council on Federal Financial Relations. National Partnership Agreement on Improving Public Hospital Services. Standing Council on Federal Financial Relations, Canberra. Viewed 10 April 2013,
<http://www.federalfinancialrelations.gov.au/content/npa/health_reform/
national-workforce-reform/national_partnership.pdf
>

Expert Panel. Review of Elective Surgery and Emergency Access Targets under the National Partnership Agreement on Improving Public Hospital Services: Report to the Council of Australian Government. Canberra: Commonwealth of Australia. Viewed 10 April 2013,
<http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/
Content/Expert-Panel-Report/$File/Expert%20Panel%20Report-D0490.pdf
>

Relational attributes

Related metadata references:Help on this term

See also National Partnership Agreement on Improving Public Hospital Services: National Emergency Access Target Health, Standard 21/11/2013

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