Complete guide to Australian hospital emergency departments — NEAT (National Emergency Access Target), ATS triage standards, ED patient flow, access block management, state performance, and ED software.
NEAT requires 100% of ED patients seen within 4 hours. Current national performance is 60-75%. Access block affects 30-40% of admitted patients. This guide covers Australian ED management.
Australasian Triage Scale (ATS)
| ATS | Category | Target Time | Examples |
|---|---|---|---|
| 1 | Immediately life-threatening | Immediately | Cardiac arrest, severe trauma |
| 2 | Imminent threat | 10 minutes | Chest pain, severe asthma, sepsis |
| 3 | Potentially serious | 30 minutes | Moderate pain, fractures, vomiting |
| 4 | Potentially serious, less urgent | 60 minutes | Minor fractures, infections |
| 5 | Less urgent | 120 minutes | Minor injuries, repeat visits |
NEAT Performance by State
| State | NEAT Compliance | Access Block |
|---|---|---|
| NSW | 65-70% | 35-40% |
| Victoria | 65-70% | 30-35% |
| Queensland | 70-75% | 25-30% |
| WA | 75-80% | 25-30% |
| SA | 65-70% | 35-40% |
| Tasmania | 60-65% | 40-45% |
| ACT | 60-65% | 40-45% |
| NT | 70-75% | 30-35% |
ED Patient Flow Optimisation
- Triage: Rapid triage with ATS — nurse triage within 5 minutes of arrival
- Fast track: Fast track for ATS 4-5 patients to reduce waiting
- See and treat: Senior doctor sees and treats in one encounter
- ED observation: ED observation unit for short-stay patients (< 24h)
- Discharge planning: Start discharge planning at ED admission
- Inpatient flow: Improve inpatient flow to reduce access block
- Virtual ED: Virtual ED for low-acuity patients — telehealth assessment
- Hospital in the Home: HITH for eligible patients — avoids admission
Frequently Asked Questions
- What is NEAT?
- NEAT (National Emergency Access Target) requires that 100% of ED patients are admitted, discharged, or transferred within 4 hours of arrival. The target was originally 90% by 2015 but was revised. Current state performance varies: 60-75% nationally. NEAT is also called the '4-hour rule'. It measures ED efficiency and access to care.
- What is the Australasian Triage Scale (ATS)?
- ATS (Australasian Triage Scale) is a 5-level triage system used in Australian and New Zealand EDs: ATS 1 (immediately life-threatening — seen immediately), ATS 2 (imminent threat — seen within 10 min), ATS 3 (potentially serious — seen within 30 min), ATS 4 (potentially serious but less urgent — seen within 60 min), ATS 5 (less urgent — seen within 120 min).
- What is access block in Australian EDs?
- Access block occurs when ED patients who need admission wait more than 8 hours for an inpatient bed. Access block affects 30-40% of admitted ED patients in Australia. Causes: 1) Hospital bed shortages, 2) Delayed discharges, 3) Aged care placement delays, 4) Staffing shortages. Access block leads to: longer ED stays, worse outcomes, higher mortality, and NEAT breaches.