SSA102; SSA106 Previous IDs:

Patients with Total time in ED <= 4hrs:

• Admitted (to a ward/ICU/theatre from ED) (%) (SSA101)

• Not Admitted (to an Inpatient Unit from ED) (%) (SSA102)

• Mental health patients admitted (to a ward/ICU/theatre from ED) (%) (SSA106)

Service Agreement Type Performance Area Status

Version number

Service Measure

Service Access and Patient Flow Final

4.0

Scope All emergency presentations where treatment has been completed Goal To improve access to public hospital services

Desired outcome • Improved patient satisfaction

• Improved efficiency of Emergency Department services Primary point of collection Emergency Department Clerk

Data Collection Source/System Emergency Department Data Collection Primary data source for

analysis HIE (ED_Visit_mrn)

Indicator definition The percentage of ED patients who either physically leave the ED for admission to hospital, are referred for treatment or are discharged, whose ED stay length is <=

4 hours, disaggregated by their mode of separation (admitted and not admitted).

ED stay length is calculated as subtracting presentation date/time from ED physical departure date/time, where:

• Presentation date/time in the ED is the time and date 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 and;

• Departure date/time is measured using the following business rules:

• If the patient is subsequently admitted to this hospital (either 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. For NSW, this is calculated using the

“Actual Departure Date and Time” field in source systems.

• If the service episode is completed without the patient being admitted,

“Departure Ready Date and Time”, or “Actual Departure Date and Time”

fields in source systems.

• If the patient did not wait, then record the time the patient leaves the emergency department or was first noticed as having left. For NSW, this is calculated using the “Actual Departure Date and Time” field in source systems.

• If the patient leaves at their own risk, then record the time the patient leaves the emergency department or was first noticed as having left. For NSW, this is calculated using the “Actual Departure Date and Time” field in source systems.

• If the patient died in the emergency department, then record the time the body was removed from the emergency department. For NSW, this is calculated using the “Actual Departure Date and Time” field in source systems.

• If the patient was dead on arrival, then record the time the body was removed from the emergency department. If an emergency department physician certified the death of the patient outside the emergency department, then record the time the patient was certified dead. For NSW, this is calculated using the “Actual Departure Date and Time” field in source systems.

Numerator

Numerator definition SSA101: All patients who have a length of stay from presentation time to actual departure time of less than or equal to 4 hours, and who are admitted to a ward, to ICU or to theatre from ED, as represented by one of the following separation modes:

‘1’, ‘10’, ‘11’

SSA102: All patients who have a length of stay from presentation time to actual departure time of less than or equal to 4 hours, and who are not admitted to a ward, to ICU or to theatre from ED.

SSA106: A subset of SSA101, identifying all mental health patients who have a length of stay from presentation time to actual departure time of less than or equal to 4 hours, and who are admitted to a ward, to ICU or to theatre from ED, as represented by the combination of one of the following separation modes:

‘1’, ‘10’, ‘11’;

Mental health patients are identified using ED principal diagnosis codes as follows:

ICD9CM:

• First three characters “294”-“301” or “306”-“314”;

• whole codes “V71.01”-“V71.09”;

• whole code “799.2”;

• whole codes “E950.00”-“E959.99”.

ICD10AM:

• First three characters “F20”-“F51” or “F53”-“F63” or “F65”-“F69” or

“F80”-“F99” or “R44”-“R45” or “X60”-“X84”);

• For codes with first two characters “F1”, include only those of from

“F1n.5” where n is an integer 0-9.

SNOMED CT (mapped to ICD10AM V6), using the

NWAU_CLINICAL_CODE_MAP table as referenced in the HIE.

Numerator source HIE (Emergency Department Data Collection) Numerator availability Available

Denominator

Denominator definition The total number of emergency department presentations reported in the reporting period

Denominator source HIE (Emergency Department Data Collection) Denominator availability Available

Inclusions • All patients presenting to the emergency department at facilities that currently provide patient episode data to the non-admitted patients ED minimum data collection

• All patients that departed during the reporting period

• Only records where “Presentation time” (i.e. triage or arrival time) and actual Departure date/time are present

• For SSA101 and SSA106, the following Emergency Department Modes of Separation values are included in calculation:

• 1- Admitted to a ward/inpatient unit, not critical care

• 10-Admitted to a critical care unit

• 11-Admitted via operating suite

• For SSA106, Mental health patients are identified using ED principal diagnosis codes from ICD 9, ICD 10 or SNOMED CT.

Exclusions • Records where total time in ED is missing. Less than zero or greater than 99,998 minutes

• Visit type in (‘12’,’13’) i.e. Telehealth presentation, current admitted patient presentation

• Separation mode = ‘99’ i.e. Registered in error

• Duplicate with same facility, MRN, arrival date, arrival time and birth date

Targets N/A

Context Improved public patient access to emergency department (ED) services by improving efficiency and capacity in public hospitals

Related Policies/ Programs • Intergovernmental Agreement on Federal Financial Relations

• Whole of Hospital Program

• Centre for Health Care Redesign

Contact - Policy Director, System Relationships Branch

Contact - Data Executive Director, Health System Information and Performance Reporting Representation

Data type Numeric

Form Number, presented as a percentage (%)

Representational layout NNN.N

Minimum size 3

Maximum size 5

Data domain

Date effective 1 July 2012

Related National Indicators National Healthcare Agreement: PI 21b-Waiting times for emergency hospital care: Proportion completed within four hours, 2015

http://meteor.aihw.gov.au/content/index.phtml/itemId/559024

National Partnership Agreement on Improving Public Hospital Services: National Emergency Access Target (Meteor ID: 489630)

http://meteor.aihw.gov.au/content/index.phtml/itemId/489630

National Partnership Agreement on Improving Public Hospital Services: National Emergency Access Target (Meteor ID: 489630)

http://meteor.aihw.gov.au/content/index.phtml/itemId/489630

THE NATIONAL HEALTH REFORM AGREEMENT - NATIONAL PARTNERSHIP AGREEMENT ON IMPROVING PUBLIC HOSPITAL SERVICES - KPI C42 http://www.federalfinancialrelations.gov.au/content/npa/health_reform/national-workforce-reform/national_partnership.pdf

Components Meteor ID 474181 Non-admitted patient emergency department service episode—service episode length, total minutes NNNNN

The amount of time, measured in minutes, between when a patient presents at an emergency department, and when the non-admitted emergency department service episode has concluded

http://meteor.aihw.gov.au/content/index.phtml/itemId/474181

Meteor ID 471889 Emergency department stay—presentation time, hhmm The time of patient presentation at the emergency department is the time of 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

http://meteor.aihw.gov.au/content/index.phtml/itemId/471889

INDICATOR: SSA104