Service Agreement - Department of Health and Human Services Tasmania: 2014, Total time (hours) spent by ambulance presentations in offload delay, 2014

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:Ambulance offload delay (hours)
Synonymous names:Ambulance offload delay; Ambulance ramping
METeOR identifier:581525
Registration status:Tasmanian Health, Archived 09/12/2016
Description:

This indicator measures the amount of time, in hours, that ambulance presentation to an emergency department resulted in offload delay (delay from triage time to handover time of more than 15 minutes). Ambulance offload delay is measured from when triage occurred while the care of the patient was still under the responsibility of ambulance officers until the care was fully transferred to the emergency department.

Rationale:

The Emergency Care Network Steering Committee and the Tasmanian Ambulance Service set the benchmark of 15 minutes for a safe and timely transfer of a patient from the care of ambulance crew to emergency department staff. 

A patient is considered to have Ambulance Offload Delay (AOD) when they are still under the care of ambulance crew 15 minutes after their arrival to the emergency department. The amount of time spent AOD is set to zero at the 15 minutes mark, consequently a patient under the care of ambulance crew and located at the emergency department for 20 minutes would be considered to have an AOD of 5 minutes.

Indicator set:Service Agreement - Department of Health and Human Services Tasmania: 2014 Tasmanian Health, Archived 12/12/2016
Outcome area:Emergency Department access Tasmanian Health, Endorsed 07/12/2016

Collection and usage attributes

Computation:

The definitions applied were set by the Emergency Care Network Steering Committee. 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.

Ambulance offload delay is calculated for ambulance presentations by subtracting the date and time the patient was triaged from the date and time the patient was transferred to the care of the emergency department. Ambulance offload delay has occurred when this figure is greater than 15 minutes (being 15:59).

The amount of ambulance offload delay time is set to zero at the 15 minute mark; consequently a patient who waited for 20 minutes would have an ambulance offload delay time of 5 minutes.

See Australasian Triage Scale from the Australasian College for Emergency Medicine for a description of each triage category, including indicative clinical descriptors.

The indicator is presented as total time, in hours.

Numerator:

Total time of ambulance presentations with delay from triage to handover time greater than 15 minutes, converted into hours

Numerator data elements:
Data Element / Data SetEmergency department stay—ambulance offload delay, total minutes NNNNN
Guide for use

Only includes records which ambulance offload delay time is over 15 minutes.

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 the patient was triaged when greater than 15 minutes.

Computation methods:

Royal Hobart Hospital

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

Launceston General Hospital

([RampEndDateTime] from the FactEmergencyConsultRamping table - [TriageStartDateTime]) when > than 15 minutes*.

North West Regional Hospital and Mersey Community Hospital

([RampEndDateTime] from the FactEmergencyConsultRamping table - [TriageStartDateTime]) when > than 15 minutes*.

* an ambulance offload delay time of over 15 minutes being below 15:59 seconds. 

Note: A patient with a waiting time (i.e. the time between being triaged at the emergency department but still under the care of the ambulance crew and the time they are attended to by emergency department staff) of 16 minutes, is considered to have has an ambulance offload delay of 1 minute.


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

Computation methods:

Royal Hobart Hospital

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 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:No denominator
Disaggregation:Specified disaggregation: Hospital, triage category and reporting month based on the date of the end of the emergency department stay
Disaggregation data elements:
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:Count
Data type:Real
Unit of measure:Time (e.g. days, hours)
Format:NNN[N]

Accountability attributes

Reporting requirements:
  • 2014-15 Service Agreement

Relational attributes

Related metadata references:

Supersedes Service Agreement - Department of Health and Human Services Tasmania: 2013, KPI??-Total time (hours) spent by ambulance presentations in offload delay, 2013 Tasmanian Health, Archived 09/12/2016