Our paper ‘Project RED—a successful methodology for improving emergency department performance,’ was recently published in the Journal.1 It was accompanied by an editorial which correctly pointed out that the ‘Shorter Stays’ target is a whole health system target, not an emergency department target.2
Our paper used two performance measures as indicators of progress. The first was waiting time for triage category 2 patients. At the time of submission of our paper 77% of triage 2 patients were being seen within 10 minutes, against a target of 80%. Our second performance measure was the percentage of patients with a total Emergency Department length of stay under 6 hours. At the time of submission our performance against this measure was 90.5%, against a target of 95%. The editorial reiterated comments in our paper that performance against the 6-hour length of stay target, known as the shorter stays in the emergency department health target, was very dependent on the ability of other parts of the system, particularly hospital inpatient services, to take patients from the emergency department.
While Project RED was necessarily an emergency department-centred project, it contributed to (and was in the context of a) growing commitment to whole of system reforms. Both Project RED and this growing commitment have seen the past several months with over 90% of triage 2 patients seen within 10 minutes and over 95% of emergency department patients with a total emergency department length of stay of less than 6 hours.
In addition to a confidence that patient care has improved in general, I have no doubt that the improved processes and enhanced relationships consequent to these and related activities over the last few years provided a strong foundation for the major internal and external incident responses to the Christchurch earthquakes.
Professor of Emergency Medicine, University of Otago, Christchurch and Emergency Medicine Physician, Christchurch Hospital