|Title:||Ambulance Arrivals and the Four Hour Rule|
|Document ID:||Operational Directive OD 0311/10|
|Date of issue:||Monday, 13 December 2010|
|Description:||Reinforces that changes are not to be made to clinical practice around ambulance arrival and associated data collection in EDIS purely for the purpose of Four Hour Rule reporting.|
|Applicable to:||All staff working in Emergency Departments or using EDIS outside the Emergency Department|
|Period of effect:||from 1 December 2010 to 1 December 2015|
|Review date:||1 December 2015|
|Authorised by:||Kim Snowball, Director General, Department of Health WA, 06-Dec-2010|
|Print version:||View print version|
Ambulance Arrivals and the Four Hour Rule
Clinical practice is in place to ensure patient safety and quality of care. EDIS is an operational system which should be used as appropriate to the support of clinical practice in the ED.
Current practice recommends that Ambulances should be triaged as soon as practicable after arrival, as this is essential for patient safety.
Data should be entered in a timely and accurate manner. This enhances information provision to the clinical setting and facilitates accurate reporting of performance for continuous improvement.
If reports are made by Ambulance Officers that there has been a delay in triage this should be investigated on a case-by-case basis by the appropriate authority.
The calculation of Length of Stay used for Four Hour Rule reporting starts at the first time recorded on arrival or triage and ends at the time of departure from the ED, unless the patient is admitted under an ED observation clinician (excluding transfers), in which case the length of stay ends at the time of admission. Four Hour Rule reporting includes cases Triaged 1 through 5 and excludes direct admissions and patients who are Dead on Arrival and not treated in the ED.
The Four Hour Rule should not impact clinical practice around ambulance arrival and the recording of data in EDIS. EDIS business rules and data collection practices should not be altered solely to accommodate secondary reporting, such as that required for the Four Hour Rule.
This circular last updated: Monday, 13 December 2010 at 10:20am