Study: England's 4-Hour ED Target Does Not Negatively Affect Quality

The four-hour target England implemented to limit patients' length of stay in the emergency department may not negatively affect quality or safety of ED care, according to a study in Annals of Emergency Medicine.

In 2005, England established a target of four hours for clinicians and staff to treat and discharge ED patients. To determine the effects of this target, researchers conducted a retrospective study of 15 EDs in England that had varying performance against the target from 2003 to 2006.

Admissions from the ED, deaths in the ED and return ED visits within one week did not change from 2003 to 2006. Return visits leading to hospital admission increased initially after the four-hour target implementation and then dropped back to 2003 levels, according to the study.

The percent of patients receiving blood tests increased from 13.8 percent to 19.8 percent, and the frequency of radiologic studies decreased from 38 percent to 35.7 percent from 2003 to 2006.

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