Lessons from the 4-hour standard in England for Australia

Peter A Cameron and Matthew W Cooke
Med J Aust 2011; 194 (1): . || doi: 10.5694/j.1326-5377.2011.tb04134.x
Published online: 3 January 2011

Timeliness is important only to the extent that high-quality patient care is preserved

Increasing demand for emergency care has worsened access to acute hospital services across the developed world. Australia’s response has been a mixture of time-based emergency department (ED) targets to drive process improvements, efforts to divert patients from EDs into community-based services and changes to accelerate hospital-wide processes and patient discharges. There has also been increased investment in bed capacity, although not commensurate with rising demand. Seasonal planning has been undertaken for both acute and sub-acute sectors. Despite these initiatives, access to acute hospital care has become measurably worse.1

  • Peter A Cameron1,2
  • Matthew W Cooke3

  • 1 Emergency and Trauma Centre, The Alfred Hospital, Melbourne, VIC.
  • 2 Centre of Research Excellence in Patient Safety, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC.
  • 3 United Kingdom Department of Health, London, UK.


Competing interests:

Peter Cameron was on recent sabbatical in the UK, which was paid for by The Alfred Hospital, Melbourne, examining the ED 4-hour rule. As the UK National Clinical Director for Urgent and Emergency Care, Matthew Cooke is responsible for developing the new indicators mentioned in the article.


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