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Lessons from the 4-hour standard in England for Australia

Roberto Forero, Geoff D McDonnell, Sally M McCarthy, Peter Nugus, Jeffrey Braithwaite, Kenneth M Hillman, Daniel M Fatovich, David Mountain, Frank F Daly, Gerard J Fitzgerald and Drew B Richardson
Med J Aust 2011; 194 (5): 268.

To the Editor: Australia is in the process of making the most important change to its health care system since the implementation of Medicare.1 We agree with Cameron and Cooke that there are important lessons for Australia from the implementation of the 4-hour rule in the United Kingdom.2 As in Robert Zemeckis’s 1985 movie classic,

Roberto Forero, Senior Research Fellow1
Geoff D McDonnell, Simulation Research Fellow2
Sally M McCarthy, Director of Emergency Medicine3
Peter Nugus, Research Fellow4
Jeffrey Braithwaite, Director4
Kenneth M Hillman, Director1
Daniel M Fatovich, Professor of Emergency Medicine5
David Mountain, Emergency Physician and Associate Professor6
Frank F Daly, Professor of Emergency Medicine7
Gerard J Fitzgerald, Professor of Public Health8
Drew B Richardson, Professor of Emergency Medicine9
1 Simpson Centre for Health Services Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW.
2 Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW.
3 Prince of Wales Hospital, Sydney, NSW.
4 Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW.
5 Centre for Clinical Research in Emergency Medicine, University of Western Australia, Perth, WA.
6 Sir Charles Gairdner Hospital and University of Western Australia, Perth, WA.
7 Royal Perth Hospital and University of Western Australia, Perth, WA.
8 Queensland University of Technology, Brisbane, QLD.
9 Canberra Hospital and Australian National University, Canberra, ACT.
Article References: 
Reference Text: 
Kirby T. Moving Australia’s health-care system into the 21st century. Lancet 2010; 376: 219-220.
Reference Order: 
1
PubMed ID: 
20669402
Reference Text: 
Cameron PA, Cooke MW. Lessons from the 4-hour standard in England for Australia [editorial]. Med J Aust 2011; 194: 4-5.
Reference Order: 
2
PubMed ID: 
Reference Text: 
United Kingdom Department of Health Urgent and Emergency Care. A&E clinical quality indicators. Data definitions. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122892.pdf (accessed Feb 2011).
Reference Order: 
3
PubMed ID: 
Reference Text: 
Forero R, Hillman KM, McCarthy SM, et al. Access block and ED overcrowding. Emerg Med Australas 2010; 22: 119-135.
Reference Order: 
4
PubMed ID: 
20534047
Reference Text: 
Paul SA, Reddy MC, DeFlitch CJ. A systematic review of simulation studies investigating emergency department overcrowding. Simulation 2010; 86: 559-571.
Reference Order: 
5
PubMed ID: 

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