Urology Annals
About UA | Search | Ahead of print | Current Issue | Archives | Instructions | Online submissionLogin 
Urology Annals
  Editorial Board | Subscribe | Advertise | Contact
Users Online: 2301   Home Print this page  Email this page Small font size Default font size Increase font size
Year : 2018  |  Volume : 10  |  Issue : 2  |  Page : 146-149

Increased burden on metropolitan urological services: The era of the Australian National Emergency Access Targets (NEAT or the “4-h target”)

1 Department of Surgery, Western Health, Footscray, VIC; Department of Surgery, Mackay Base Hospital, Mackay; The University of Queensland, School of Medicine, Brisbane, Australia
2 Department of Surgery, Western Health, Footscray, VIC, Mackay, Australia
3 Department of Surgery, Mackay Base Hospital, Mackay; The University of Queensland, School of Medicine, Brisbane; The University of Queensland, Centre for Clinical Research, Brisbane, QLD 4006, Australia
4 Department of Surgery, University of Melbourne, Austin Hospital; Olivia Newton-John Cancer Research Institute, Austin Hospital; Peter MacCallum Cancer Centre, Division of Cancer Surgery, Melbourne, Australia
5 Department of Emergency, Western Health, Footscray VIC, QLD, Mackay, Australia
6 Department of Surgery, Western Health, Footscray, VIC, Mackay; Academic Surgery, University of Melbourne, VIC, Australia

Correspondence Address:
Dr. Marlon L Perera
Department of Surgery, Western Health, Gordon St, Footscray VIC, QLD, Mackay, Australia
Login to access the Email id

DOI: 10.4103/0974-7796.164843

PMID: 29719324

Rights and Permissions

Background: The National Emergency Access Targets (NEAT) was introduced in Australia in 2011 and guides the clearance of presentations within 4-h of initial presentation from the Emergency Department (ED). We aim to assess the impact of the introduction of NEAT on acute urological services at a large metropolitan center. Methods: A retrospective cohort study was performed and data were collected from electronic patient management systems. The control group was represented by ED presentations between June and September 2011, 1 year prior to the introduction of NEAT. The two study groups consisted of ED presentations between June and September 2012 and 2013, respectively. Outcome measures included time to the ureteric stent and scrotal exploration, inpatient length of stay (IPLOS), out-of-hours operating, and hospital mortality rates. Results: Across the three study periods, a total of 76,935 patients were assessed by the EDs of the health service. 225 urological inpatient episodes were included across all periods with a trend showing increasing numbers of admissions (P = 0.003). For patients admitted under the urological service: Waiting room time and ED length of stay decreased significantly (P < 0.001). Proportion of operative cases decreased insignificantly (P = 0.275). Time from emergency presentation to emergency ureteric stent remained unchanged, however, proportions of procedures performed out-of-hours showed an increasing trend (P < 0.001). A significant increase in inter-unit transfer was observed, however, median IPLOS and mortality for operative and nonoperative cases remain unchanged. Conclusions: Concerning urological admissions, the implementation of NEAT has been associated with improvement in ED key performance indicators. Such changes have been correlated with reductions in operative cases and increases in out-of-hours emergency operating. Further research is required to evaluate the direct effect of NEAT on urological patient care.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded253    
    Comments [Add]    

Recommend this journal