First report shows large variation in hospital performance

There are large variations between hospitals in the percentage of patients who leave emergency departments (EDs) within the four-hour timeframe adopted by Australian governments, the first report from the National Health Performance Authority has found.

Released today, the report, Hospital Performance: Time patients spent in emergency departments in 2011-12, finds that hospital size and location, and whether patients are admitted or discharged, influences the likelihood of meeting the National Emergency Access Target (NEAT) introduced this year.

The report groups hospitals according to size and location, allowing for the first time fair comparisons to be drawn between similar hospitals nationally.

The report shows:

  • Major hospitals, which account for 4 million visits annually, recorded the lowest percentages of patients departing EDs within four hours (major metropolitan hospitals 54%, and major regional hospitals 63%).
  • Hospitals in metropolitan areas recorded lower percentages of all patients leaving EDs within four hours than regional hospitals of similar size (major metropolitan hospitals 54%, and major regional 63%; and large metropolitan hospitals 67%, compared to large regional 78%).
  • Admitted patients took the longest to leave EDs compared to discharged patients, and this trend was felt across all peer groups. In the major metropolitan and regional hospital peer groups, the percentage of subsequently admitted patients who left ED within four hours was 26% and 24%, respectively, compared to 70% and 78% respectively in the case of discharged patients at the same hospital peer groups.

As part of the NEAT, states and territories have agreed varying targets for the percentage of patients who leave ED within four hours, rising progressively in 2012, 2013 and 2014. In 2015, the target will synchronise nationally at 90% of all patients leaving ED within four hours.

Authority CEO Dr Diane Watson said the report showed hospitals where they sit in the pack and would help them learn from those that were already achieving the 90% target, or were closer to doing so.

“This target aims to ensure 90% of patients leave hospital EDs within four hours by 2015. Each state has agreed lower targets for 2012, 2013 and 2014,” Dr Watson said.

“In 2012 most states are aiming for roughly 60% or 70% of patients to depart an ED within four hours. These targets increase progressively each year until 2015.”

Although there are a number of hospitals already meeting the applicable state target, large variations were also seen between individual hospitals.

While 54% of all patients left EDs within four hours at major metropolitan hospitals when these hospitals were considered as a group, the percentage at individual hospitals within this group ranged from 74% to 33%.

At major regional hospitals, the range was from 79% to 47%; at large metropolitan hospitals, from 83% to 48%, and at large regional hospitals from 92% to 61%.

“This report lets hospitals see where they are placed at the starting line of national performance reporting, and allows for meaningful performance between comparable groups of hospitals so attention can be focused on those who need to improve – and on those from whom others can learn,” Dr Watson said.

The report is based on an analysis of about 5.9 million ED presentations to 134 public hospital emergency departments in 2011-12.

The first hospitals report is released at the same time as updated MyHospitals information, including elective surgery waiting times and hand hygiene.

The National Health Performance Authority was established under the National Health Reform Act 2011 as an independent agency which reports regularly on the comparable performance of healthcare organisations and other organisations that provide health services.

The Authority will report performance in respect of nearly 50 indicators agreed to by the Council of Australian Governments.

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