title: Emergency department performance at a small rural hospital: an independent in-depth review.
abstract: OBJECTIVE
  This study aims to provide a retrospective review of the recent performance of the emergency department of Cobram District Hospital, a small rural hospital located on the border of Victoria and New South Wales.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Small rural accident and emergency department.
  
  
  METHODS
  All available data collected from the emergency department from the previous three financial years (July 2005 to June 2008) were compiled onto a computerised spreadsheet and analysed by two independent investigators.
  
  
  METHODS
  Key performance indicators, including time for patient to be seen by a doctor and frequency of patient presentations to the emergency department.
  
  
  RESULTS
  Cobram District Hospital has fewer than 5000 patients presenting to the emergency department each year. 12 p.m. to 12 a.m. accounts for 69% of all presentations, with three notable time periods that experience most presentations. Life-threatening emergencies represented <3% of all presentations to the emergency department. Patients in triage categories 1-3 did not met Australasian triage scale (ATS)-suggested time for maximum waiting timing, while categories 4 and 5 well exceeded ATS standards.
  
  
  CONCLUSIONS
  The small size and lack of dedicated emergency department staff place restrictions on the ability of an unfunded rural hospital to match the performance of major metropolitan emergency departments. ATS guidelines should be revised to improve clarity and reflect the different performance capabilities between metropolitan and rural centres.
authors.affiliation: Royal Melbourne Hospital Clinical School, The Royal Melbourne Hospital, Parkville, Australia. ptescher@hotmail.com
authors.forename: Paul
authors.initials: P
authors.lastname: Tescher
authors.forename: Tony Mengxi
authors.initials: TM
authors.lastname: Chen
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006780:Hospitals, Rural / Q000706:statistics & numerical data*; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data; D009517:New South Wales; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage; D014739:Victoria