BENDIGO HEALTH

Emergency Department Key Performance Indicators

A guide for nursing staff working in the emergency department
Prepared by Carol-Anne Lever NUM

2010

BENDIGO HEALTH EMERGENCY DEPARTMENT

Emergency department Key Performance Indicators (KPIs)

Emergency department KPIs put are measures used to evaluate emergency department performance. KPIs are set out by the department of health (DOH) and used to benchmark all public hospital emergency departments in Victoria and to measure the success (or otherwise) of emergency department performance. Bendigo Health is required by the DOH to report data collected by the VEMD (Victorian Emergency Minimum Dataset) on a weekly basis. This data forms the basis for reporting on all KPIs. It is absolutely imperative that nursing staff accurately complete all data entry requirements (i.e. field 9 and entering discharge times on the MCATS system) so that we can report accurate data to monitor our performance.

Data entry and KPIs

Nursing staff in the emergency department are required to accurately document in the patients record the when they first see and assess the patient and all subsequent care given. It is also a requirement to document when the patient has been discharged from emergency department care (i.e. when the patient has been discharged home, admitted to an inpatient bed or transferred) An extension of the written documentation is to enter relevant times in to the computer system. This is not only a legal and professional requirement but a requirement to ensure our KPIs are an actual reflection of the care we give.

What are our KPIs?

Following is a brief outline and description of emergency department KPIs:

Time to treatment kpi: Time to treatment KPI is measured against triage categories for each patient presenting to the emergency department. Patients are triaged according to the Australasian Triage Scale. The time from when the patient is triaged to when treatment commenced is the time measured. Treatment commences when the patient is first seen by the doctor OR when the nurse sees the patient and commences an established treatment pathway (ie obs, cannulation, ecg, nurse initiated medications etc) In many instances it is the nurse who first sees the patient and commences treatment. If this is the case then it is imperative that the nurse not only document in the patient notes the time first seen but also enter the actual time first seen in field 9 on the computer. This should ideally be done in real time but may be entered as soon a practical after the patient has been assessed and treatment pathway commenced. Time to treatment kpi is only as accurate as data entered.

Patients seen and discharged within 4 hours of presentation : The LOS for patients seen, treated and discharged from the emergency department should not exceed 4 hours. For accurate kpi measurement the discharge time must be entered when the patient leaves the department by the person discharging the patient.

Patients seen, treated and admitted to an inpatient bed from the ED : The LOS for patients treated and admitted from the emergency department should not exceed 8 hours. For accurate kpi measurement the discharge time must be entered by the person transferring the patient to the ward. LOS greater than 24 hours in the emergency department: The number of patients with LOS greater than 24/7 should be zero. For accurate kpi measurement the correct discharge time must be entered when the patient is discharged.

How do I know how the emergency department is performing with regard to DOH KPIs?
Bendigo Health data performance unit publishes a KPI Dashboard weekly. The weekly dashboard reports our ED performance and the data presented here comes directly from data entered by staff in the ED. The dashboard can be found on the staff notice board outside the tea room every Tuesday and will be displayed weekly. The DOH also publishes data on a quarterly basis which will be distributed to staff when available by the NUM. This quarterly data also shows how every emergency department in the state is performing and allows us to benchmark our service against others.

Summary
As nurses we measure our performance in many important ways such as successful clinical outcomes, how busy our day has been and how sore our feet and brains are by the end of a shift! KPIs as required by the DOH measure our performance as a department for Bendigo Health as an organization, the state government and for the public. The data is published on the DOH web site for transparency and comparison.

It is the responsibility of each and every staff member to accurately enter the time the patient is seen and discharged. If data is accurate it can form the basis of argument for extra resources which may be needed. If there are any questions relating to KPIs please dont hesitate to ask.