• Thomas Woodward, Julia Hocking, Lucy James, and David Johnson.
• Emergency Department, Hervey Bay Hospital, Hervey Bay, Queensland, Australia.
• Emerg Med Australas. 2019 Apr 1; 31 (2): 200-204.

ObjectiveED access block is an ongoing significant problem and has been associated with excess mortality. Multiple models of care have been studied in an effort to improve access block and other key performance indicators (KPIs) of ED.MethodsThis present study describes the impact of a new model of care using an ED led, consultant run clinical decision unit (CDU) on performance, using a retrospective analysis of data for 9 month periods before and after the introduction of the CDU model of care. Primary outcomes were access block (percentage of patients admitted >8 h), discharge National Emergency Access Target (NEAT) adherence and Queensland Ambulance Service level three escalations.ResultsAfter the implementation of the CDU, access block significantly improved. There was a significant improvement in NEAT adherence. Total ambulance ramping time fell by 58% and ambulance service level three escalations fell from 21 to 5 post-CDU implementation. Overall there was no change to hospital mortality numbers. The percentage of patients that did not wait and 30 day representations showed a small but statistically significant decrease.ConclusionIn summary, this ED led, consultant run CDU model of care resulted in significantly improved performance on a range of KPIs, including improvement in access block and NEAT figures. The substantial improvements in ambulance ramping and escalations also indicated that the department was able to cope better with periods of high activity.© 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

26 keywords...

hide…