Timely Emergency Care

A collaboration between 14 health services, Ambulance Victoria, the department and IHI, focused on improving emergency care timeliness through whole-of-hospital flow. Health services tested and implemented changes across three focus areas (‘workstreams’):

• Hospital wide operations – improving the coordination of patient flow across the hospital to support timely care
• Emergency – improving the management of patient flow within emergency departments and short stay units
• Inpatient – improving the management of patient flow within inpatient wards

Key results

TECC resulted in measurable improvements across our hospitals including:

• Reduced emergency department delays
  • 10% reduction in time spent in ED for patients requiring admission
  • 4% reduction in ED waiting times for patients not needing admission
  • 11% faster ambulance handover times supporting quicker ambulance turnaround and faster access to care
• Faster access to inpatient care
  • 4% reduction in time to admission decision, reducing pressure on emergency departments
• Earlier and more consistent discharges
  • 5% increase in discharges by midday, creating earlier bed capacity for peak demand
• Shorter hospital stays
  • 3% decrease in inpatient length of stay, freeing up bed capacity

An expanded program across 28 sites, supporting frontline staff to design, and test targeted improvements across emergency, inpatient and discharge processes, including new and expanded home-based and older person care models. TEC2 included three areas of focus:

• Optimising Flow – improving how patients move through hospitals to reduce delays in emergency care (14 hospitals)
• Excellence in Flow – supporting better care for older people so they spend less time in hospital and avoid unnecessary stays (13 hospitals)
• Innovation in Flow – tackling complex barriers to patient flow by testing practical solutions, such as increasing weekend discharges, to deliver timely and safe improvements to patient care (23 hospitals)

Key results

TEC2 resulted in measurable improvements across our hospitals including:

• Reduced emergency department delays 
  • ED short stay patients treated and discharged up to an hour sooner on average, creating capacity for around 13,132additional patients
• Faster access to inpatient care 
  • Admitted patients discharged 9.6 hours earlier on average, freeing the more than 66,000 bed days– the equivalent of four hospital wards capacity every day
• Better use of hospital beds 
  • More than 3,000 unnecessary admissions avoided for older patients,through new and expanded models of care, freeing over 16,300 bed days – the equivalent of an additional hospital ward of capacity every day
• Earlier and more consistent discharges 

Improved seven-day flow and increased the number of weekend discharges across the five sites participating in the weekend discharges pilot program by 3 per cent.