title: Mid-term NEAT review: analysing the improvements in hospital ED performance.
abstract: Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. Recent reports however show that the majority of hospitals are still far from being able to meet this target. We investigate the NEAT journey of 30 Queensland hospitals over the past two years and compare this performance to a previous study that investigated the 4 hour ED discharge performance of these hospitals at various times of day and under varying occupancy conditions. Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.
authors.affiliation: The CSIRO Australian E-Health Research Centre, Brisbane, Australia.
authors.forename: Sankalp
authors.initials: S
authors.lastname: Khanna
authors.affiliation: The CSIRO Australian E-Health Research Centre, Brisbane, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Boyle
authors.affiliation: The CSIRO Australian E-Health Research Centre, Brisbane, Australia.
authors.forename: Norm
authors.initials: N
authors.lastname: Good
authors.affiliation: Gold Coast Hospital, Queensland Health, Gold Coast, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Lind
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data*; D003441:Crowding; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005869:Ghana; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D013997:Time Factors; D014850:Waiting Lists; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data*