The six hour target and total daily attendances cohort study

Aims In 2012 the Emergency Medicine Programme set a six hour time standard for 95% of patients at-tending Emergency Departments (ED) in Ireland to have their care completed. This study explores the impact of total daily attendances to an adult ED on the delivery of timely care. 

Methods A retrospective cohort study of 58,323 ED attendances was performed. The impacts of variables identified from the peer reviewed literature on the likelihood of a patient achieving timely care were examined. SPSS version 24 was used for analysis. 

Results The 6-hour target was achieved for 23,461 (40.2%) patients. Total daily attendances ranged from 99 to 222 attendances per day with a mean of 164 (sd 25.9) and a median of170 patients. On days where the median daily attendance was surpassed the target was more likely to be achieved (OR 1.11; 95%CI 1.08 to 1.15). Referral for admission and requiring admission (OR 0.12; 95%CI 0.11 to 0.13) reduced the likelihood of completing the ED stay in a timely manner.

Conclusion The challenge is not that too many patients are seeking Emergency Department care but that too many patients spend too long in the Emergency Department.