New emergency department quality measure: from access block to National Emergency Access Target compliance.

Objectives: The study aims to investigate the effect of time of day and ED occupancy on the ability of EDs to admit or discharge patients within 4 h in accordance with the National Emergency Access Target (NEAT), and to compare this with corresponding levels of access block, the measure for ED performance before NEAT.

Methods: This is a retrospective analysis of 5 years of ED data from 30 reporting public hospitals in Queensland, Australia. Relationships between these and variations in time of day and occupancy were explored using a Poisson generalised linear model.

Hospital level analysis to improve patient flow.

The complexity of hospital operations ensures that one-size-fits-all solutions seldom work. As hospitals turn to evidence based strategies to redesign flow, it is critical that they tailor the strategies to suit their individual service. This paper analyses the effect of hospital occupancy on inpatient and emergency department patient flow parameters at the Caboolture hospital in Queensland, Australia, and identifies critical levels, or choke points, that result in performance decline.

Unravelling relationships: Hospital occupancy levels, discharge timing and emergency department access block.

Objectives: To investigate the effect of hospital occupancy levels on inpatient and ED patient flow parameters, and to simulate the impact of shifting discharge timing on occupancy levels.

Methods: Retrospective analysis of hospital inpatient data and ED data from 23 reporting public hospitals in Queensland, Australia, across 30 months. Relationships between outcome measures were explored through the aggregation of the historic data into 21 912 hourly intervals.

Early discharge and its effect on ED length of stay and access block.

Effecting early discharge is a widely recommended strategy for improving patient flow in acute hospitals. This paper analyses the impact of inpatient discharge timing on Emergency Department (ED) flow parameters such as access block and length of stay, while comparing this to the effect on hospital occupancy, to arrive at an understanding of a 'whole of hospital' response to discharge timing. The impact of hospital size is also investigated.

Impact of admission and discharge peak times on hospital overcrowding.

The ability of hospital staff to get a patient to the right bed at the right time is dependent on bed occupancy, and is a key issue in all acute hospitals. This paper seeks to identify the impact of admission and discharge timing on hospital occupancy with reference to the peak in daily admissions and discharges. Patient admissions data from 23 Queensland public hospitals was classified into categories based on the relative timing of daily admission and discharge curves.