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The "4-hour target": emergency nurses' views.

Andy Mortimore¹, Simon Cooper

¹Emergency Department, Torbay Hospital, Lawes Bridge, Torquay, Devon, TQ2 7AA, UK. andy.mortimore@nhs.net

Emergency Medicine Journal : EMJ

|May 22, 2007

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Nurses found the 4-hour target successful for reducing emergency department wait times and improving patient satisfaction. However, concerns remain regarding workload, care quality, and inter-departmental support.

Area of Science:

Healthcare Management
Emergency Medicine
Nursing Practice

Background:

The implementation of performance targets in healthcare aims to improve efficiency and patient outcomes.
The 4-hour target in emergency departments (EDs) is a key performance indicator in the UK.
Understanding frontline staff perspectives is crucial for evaluating such targets.

Purpose of the Study:

To explore nurses' views on the 4-hour target in an emergency department.
To identify perceived advantages and disadvantages of the 4-hour target from nursing staff perspectives.

Main Methods:

A generic qualitative approach was employed in one UK emergency department.
Semi-structured interviews were conducted with a stratified sample of nine experienced ED nurses.

Related Experiment Videos

Framework analysis was used for data analysis.

Main Results:

The 4-hour target was perceived as successful in reducing patient waiting times and enhancing satisfaction.
Nurses raised concerns about the imposed nature of the target, increased workload, and potential impact on care quality.
Inadequate support from primary and secondary care services was also highlighted as a disadvantage.

Conclusions:

While the 4-hour target shows overall success, its long-term sustainability is questioned.
Recommendations include enhancing communication between primary and secondary care.
Establishing the target as a shared, integrated goal within the hospital is advised.