title: Feeling the HEAT: Using Hourly Emergency Activity Tracking to demonstrate a novel method of describing activity and patient flow.
abstract: OBJECTIVE
  The objective of the present study is to demonstrate a novel method of mapping ED activity to analyse patterns presentations, occupancy and performance trends.
  
  
  METHODS
  This was a retrospective, descriptive analysis of de-identified and linked ED presentations across NSW, Australia, over five calendar years, 2010-2014. It was undertaken as part of the Demand for Emergency Services Trend in Years 2010-2014 (DESTINY) study. The DESTINY project analysed 10.8 million presentations during 2010-2014. Hourly Emergency Activity Tracking (HEAT) maps were generated to visually represent and analyse the number of emergency arrivals to ED occupancy and proportion of patients leaving the ED within 4 h per hour of day across consecutive months of the year.
  
  
  RESULTS
  HEAT maps provided a means of visually representing ED activity to demonstrate hour-to-hour trends in presentations, occupancy and performance between 2010 and 2014. This analysis has shown that the most marked increase in presentations per hour has occurred during the 10.00-14.00 hour period, associated with an improvement in ED performance during the same period.
  
  
  CONCLUSIONS
  HEAT maps may be used to facilitate further analyses of ED demand, patterns of patient presentations and patient flow and future health system redesign.
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kendall J
authors.initials: KJ
authors.lastname: Bein
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia.|Faculty of Nursing, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Saartje
authors.initials: S
authors.lastname: Berendsen Russell
authors.affiliation: School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Muscatello
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Dane
authors.initials: D
authors.lastname: Chalkley
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia.|School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
authors.affiliation: Emergency Department, Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia.|Discipline of Emergency Medicine, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dinh
mesh_terms: D001315:Australia; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data* / Q000639:trends; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D000066477:Work Performance / Q000706:statistics & numerical data* / Q000639:trends
keywords: activity; emergency department; performance