The report of the Expert Panel Review of Elective Surgery and Emergency Access has been released, outlining a program of investment and whole-of-hospital change that would be necessary to achieve the targets set out in the Targets National Partnership Agreement on Improving Public Hospital Services.

 

The panel, chaired by Professor Christopher Baggoley, set out a series of guiding principles and recommendations, calling for leadership at all levels to achieve them – from Ministers, Commonwealth, state and territory health departments, key stakeholders, Local Hospital Networks, Lead Clinicians Groups, hospital managers and clinicians.

 

The panel concluded that, rather than an end in themselves, the emergency department and elective surgery targets should be seen as a tool to drive process and systemic change and a measure against which to monitor progress.

 

“The foremost aim of the targets is to improve patient safety and quality of care by removing obstacles to patient flow that contribute to emergency department overcrowding and patients waiting too long for surgery. In doing so, the targets seek to reduce the morbidity and mortality linked to access block and improve the patient experience throughout the hospital system. Consumers over time should expect to see an improvement in the length of time they wait to receive emergency department and elective surgery services," the report says.

 

Amongst the 15 recommendations were:

  • That surgical taskforces, as already exist in some jurisdictions, be established in all jurisdictions and linked nationally as a means of sharing information on best practice elective surgery waiting list management.
  • That the four hour National Access Target for Emergency Departments be retained but renamed the ‘National Emergency Access Target’ (‘NEAT’) to change the focus from being entirely on the emergency department to emphasise the whole-of-hospital changes that are required to improve emergency patients’ access to care.
  • That hospitals and Local Hospital Networks collect a suite of indicators to measure the impact of the implementation of both the National Emergency Access Target and the National Elective Surgery Target  on the safety and quality of patient care.
  • That ‘clinically appropriate’ and other exclusions be incorporated into a revised target of 90 per cent of patients leaving the emergency department within four hours of presentation – either by admission, transfer to another hospital, or discharge.
  • As a matter of urgency, national definitions for elective surgery urgency categories be further developed, agreed and implemented across all states and territories. This should be led by the Australian Institute of Health and Welfare, working with the Royal Australasian College of Surgeons, and replace the planned review under the existing Clause A47 of the National Partnership Agreement on Improving Public Hospital Services.
  • That the current elective surgery target and the National Access Guarantee be replaced by a National Elective Surgery Target (NEST) where 100 per cent of patients are treated within clinically recommended times, across all urgency categories.

 

The Expert Panel Report is available here.