Media backgrounder
The Bureau independently reports on hospital performance and from time to time will review measures it uses to accurately reflect performance. For example in 2011, we reviewed our reporting on elective surgery when we noticed a high percentage of non-urgent patients waiting one day or less to be treated. We also reviewed the emergency department triagetargets and decided to introduce the median and 95th percentile times as our preferred method of measuring performance.
The Bureau recently received access to transfer of care information and included the new transfer of care measure in the April to June 2013 edition of Hospital Quarterly to moreaccurately reflect a patient’s journey in the emergency department.
Transfer of Care
- Transfer of care is the time taken for the care of a patient to be transferred from the Ambulance paramedics to the care of emergency department (ED) clinicians
- It has been introduced in addition to the previously reported measure off-stretcher time to provide a more complete picture of hospital performance
- While both measures focus on the transfer of patients from ambulance to the ED, transfer of care more closely reflects a patients experience while off stretcher time is a better reflection of Ambulance time spent at the emergency department
- This report highlights differences between transfer of care and off stretcher time measures and provides insights to be gained from their reporting
The difference between transfer of care and off stretcher time
- Both transfer of care and off stretcher time start when the ambulance arrives at the ED. However transfer of care ends when the ED staff accepts care of the patient, while off-stretcher time continues until ambulance paramedics return to their vehicle
- Transfer of care time and off-stretcher time are overlapping but distinct measures - differing in purpose, definition and interpretation
Measuring transfer of care
- Transfer of care is measured using ‘matched’ records
- ‘Matched records’ are those where the ambulance incident number and data can be matched to a patients record in the ED
- On some occasions records are ‘unmatched’. This usually occurs for patients who are directly sent to another part of the hospital, for example to a ward or to the operating theatre or, have missing data fields or clerical issues that prevent matchingof the ED and the Ambulance records
- The bureau does not use these unmatched records to calculate transfer of care
- For the state as a whole, the percentage of records that were unmatched was 13% in the April to June 2013 quarter
Variation in reporting of transfer of care
- As a performance measure, transfer of care time provides new and valuable information that, along with the information provided by off-stretcher time provides a more complete picture of hospital and system performance
Independent reporting of both measures
- The Bureau independently reports on the performance of the NSW public hospital system
- Its role is to identify and report the most relevant measures and use the most accurate data available at the time to provide a comprehensive analysis of NSW hospital performance