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INDICATOR NAME
Name
Average time patients spent (wait and treatment) in emergency department
Alternate Name
Average length of stay for patients in emergency department
 
INDICATOR DESCRIPTION
Description

This indicator measures the average time (hours) that patients can expect to spend in the emergency department (ED) waiting for and receiving treatment. The ED length of stay (LOS) is calculated as the average time interval between the earlier of triage date/time or registration date/time and the date/time when a patient is admitted to the hospital or discharged from the ED (non-admitted patients). A lower number is better. Provincial targets have been set for the maximum amount of time patients should spend in the ED, waiting and being treated, before being discharged or admitted to the hospital, based on clinical evidence. 

HQO Reporting tool/product
Public reporting
Dimension
Timely
Type
Process
 
DEFINITION AND SOURCE INFORMATION
Unit of Measurement
Hours
Calculation Methods

The average time spent in ED is calculated by dividing total time spent in the ED by total number of ED visits.

Inclusion Criteria:

  1. ED visits with a valid and known registration date/time or triage date/time and a valid and known date/time patient left the ED or disposition date/time
  2. Admitted Patients: unscheduled emergency visits with Disposition Codes 06 - 07
  3. Non-admitted Patients with CTAS level 1-5: unscheduled emergency visits with Disposition Codes 01, 03-05, 08-15

Exclusion Criteria:

  1. Scheduled visits to the emergency department
  2. ED visits with Visit Disposition 02 (Left without being seen or triaged)
  3. Visits with both unknown/invalid registration and triage date/time OR with unknown/invalid patient left ED date/time
  4. Negative ER LOS (i.e. the registration or triage date/time is after the date/time that the patient left ER)
  5. Duplicate records within the same functional centre
  6. Detailed exclusion based on the year of data:
From July 2015 onwards:
Cases where Registration date/time and Triage date/time are both blank/unknown (9999)
Cases where the MIS functional centre not under General Emergency Department ('713102000' '723102000' '733102000') or Urgent Care Centre ('713102500' '723102500' '733102500') - as of January 2015 data
Duplicate cases within the same functional centre where all ED data elements have the same values except for Abstract ID number
Cases where ED visit indicator is = "0" (i.e. scheduled ED visit)
Cases where Patient Left ED date/time are blank/unknown (9999)
Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 or 03)
Cases where EDLOS is greater than or equal to 100,000 minutes (1,666 hours)

April 2013 to June 2015:
Cases where Registration date/time and Triage date/time are both blank/unknown (9999)
Cases where the MIS functional centre not under General Emergency Department ('713102000' '723102000' '733102000') or Urgent Care Centre ('713102500' '723102500' '733102500') - as of January 2015 data
Duplicate cases within the same functional centre where all ED data elements have the same values except for Abstract ID number
Cases where ED visit indicator is = "0" (i.e. scheduled ED visit)
Cases where Patient Left ED date/time are blank/unknown (9999)
Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 or 03)
Cases where EDLOS is greater than or equal to 100,000 minutes (1,666 hours)

From FY 11/12 to FY 12/13:
Cases where Patient Left ED Date/Time and Disposition Date/Time are both blank/unknown (9999)
Cases where Registration Date/Time and Triage Date/Time are both blank/unknown (9999)
Cases where patients over the age of 125 on the earlier of triage or registration date
Duplicate cases within the same functional center where all ER data elements have the same values except for Abstract ID number
Cases where Scheduled Visit Indicator flag is = "Y" (i.e. scheduled ED visit)
Cases where Patient left ED date/time is unknown or blank and the Disposition Code is 06-09, 12, 14 (admitted and transferred patients)
Cases where patient has left without being seen by a physician during his/her visit (Disposition Code 02 or 03)
Cases where EDLOS is greater than or equal to 100,000 minutes (1,666 hours)

Numerator (short description i.e. not inclusions/exclusions)

NA

Denominator (short description i.e. not inclusions/exclusions)

NA

Adjustment (risk, age/sex standardization)- generalized
None
Data Source
National Ambulatory Care Reporting System (NACRS)
Data provided to HQO by
Cancer Care Ontario (CCO)
Reported Levels of comparability /stratifications (defined)
Acuity Level, Institution, Province, Time
 
OTHER RELEVANT INFORMATION
Caveats and Limitations
1. Scheduled visits to the ED are excluded from this analysis. 2. Patients who registered in ED but left without being seen or triaged are not included in the analysis. 3. For non-admitted patients, patients who left without seen or treatment and who left after triage and initiation of treatment are included in the analysis. 4. This indicator can also be calculated with percentiles, such as the 50th or 90th percentile. 5. Many factors can influence the indicator results, including triage level, patient population and hospital resources. 6. Depending on the acuity of the case or hospital procedures, triage may occur before registration or vice versa. Therefore, the earlier of these 2 events is used as the starting point for calculation of this indicator.
 
TAGS
Sector
Acute Care/Hospital
Type
Process
Topic
Wait Times
Dimension
Timely
Source
National Ambulatory Care Reporting System (NACRS)
 
PUBLISH
Publish Datetime
20/11/2018 15:43:00