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Appendix: Impact of redesign on emergency and elective access in 24 New South Wales hospitals from the financial years 2004–05 to 2006–07

Med J Aust 2008; 188 (6): S36. || doi: 10.5694/j.1326-5377.2008.tb01673.x
Published online: 17 March 2008

Demand, as reflected in emergency department attendances, rose in all hospitals (range, 5%–27%) and surgical activity rose 2% across NSW over this period, yet performance on emergency and elective access indicators improved or was steady in 85 of the 95 possible instances for the four outcomes presented.

Patient volume increases


Outcomes


Hospital

ED attendances

Admissions through ED

Projects

EAP*

Triage 3*

Triage 4*

Long-wait elective surgery list


St George

↑ 18%

↑ 16%

• Emergency patient flow;
• Discharge planning;
• Mental health emergency access;
• Acute coronary care syndrome;
• Ambulance case distribution

16

↑ 23

↑ 19

475 to 0

St Vincent’s

↑ 26%

↑ 29%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution

↑ 11

↓ 3

↑ 4

195 to 0

Prince of Wales

↑ 18%

↑ 25%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution

↑ 13

↑ 17

↑ 13

303 to 0

Sutherland

↑ 20%

↑ 28%

•  Emergency patient flow;
•  Discharge planning;
•  Acute coronary care syndrome;
•  Ambulance case distribution

↑ 22

↓ 2 

↑ 10

Data unavailable

Wollongong

↑ 18%

↑ 16%

•  Emergency patient flow;
•  Discharge planning;
•  Acute coronary care syndrome

↑ 20

↑ 24

↑ 16

15 to 3

Royal North Shore

↑ 18%

↑ 18%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 5 

↑ 3 

↑ 5 

70 to 11

Bankstown

↑ 27%

↑ 13%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 34

↑ 8

↑ 16 

264 to 0

Concord

↑ 19%

↑ 6%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 24

↑ 4

↑ 9

175 to 0

Campbelltown

↑ 27%

↑ 6%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↓ 2 

↑ 14

↑ 12

332 to 0

Liverpool

↑ 22%

↑ 45%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 10

↑ 21

↑ 16

219 to 0

Royal Prince Alfred

↑ 20%

↑ 34%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 12

↑ 14

↑ 8

79 to 0

Lismore

↑ 13%

↑ 13%

•  Emergency patient flow;
•  Discharge planning

↓ 2

↑ 13

↑ 17

149 to 0

Port Macquarie

↑ 21%

↑ 2%

•  Emergency patient flow;
•  Discharge planning

↑ 5

↓ 3

↓ 2

227 to 0

Tweed

↑ 5%

↑ 43%

•  Emergency patient flow;
•  Discharge planning

↓ 12

↑ 5

Steady

63 to 5

The Children’s Hospital at Westmead

↑ 22%

↑ 16%

•  Emergency patient flow;
•  Discharge planning;
•  Redesign of booked surgery

↑ 9

↑ 21

↑ 23

25 to 0

Blacktown

↑ 18%

↑ 11%

•  Emergency patient flow;
•  Discharge planning;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 18

Steady

↑ 5

25 to 4

Newcastle Calvary Mater

↑ 16%

↑ 20%

•  Emergency patient flow;
•  Discharge planning

Steady

↑ 4

↑ 4

Steady at 0

John Hunter

↑ 12%

↑ 18%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 21

↑ 30

↑ 32

15 to 0

Belmont

↑ 11%

↑ 16%

•  Emergency patient flow;
•  Discharge planning;
•  Redesign of booked surgery

↑ 11

↑ 5

↑ 8

Steady at 0

Dubbo

↑ 8%

↑ 3%

•  Emergency patient flow;
•  Discharge planning;
•  Redesign of booked surgery

↓ 4

↑ 3

↓ 5

Steady at 0

Gosford

↑ 9%

↑ 6%

•  Emergency patient flow;
•  Discharge planning;
•  Acute coronary care syndrome

Steady

↑ 7

Steady

367 to 39

Westmead

↑ 24%

↑ 23%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 11

↑ 31

↑ 28

23 to 0

Nepean

↑ 22%

↑ 21%

•  Emergency patient flow;
•  Discharge planning;
•  Mental health emergency access;
•  Acute coronary care syndrome;
•  Ambulance case distribution;
•  Redesign of booked surgery

↑ 12

↓ 3

↑ 4

537 to 0


ED = emergency department. EAP = emergency admission performance (% of admissions through ED who egress from the ED within 8 h). Triage 3 = triage 3 performance (% of patients in triage category 3 whose treatment is commenced within 30 minutes of arrival). Triage 4 = triage 4 performance (% of patients in triage category 4 whose treatment is commenced within 60 minutes of arrival.

* Percentage point change (eg, improvement from 63% to 75% is 12). Change in the number of patients who have waited more than 365 days for surgery. John Hunter outcomes data cover the period commencing in 2002, as redesign commenced earlier in this hospital.

Source: Tony Dunn, Director, Data Analysis and Performance Evaluation Branch, NSW Health, December 2007.



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