Variation in resources and impact on performance: results of the emergency department benchmarking survey

The resources and capacity of New Zealand's emergency departments (EDs) to cope with surges in demand are unknown. The aims were to describe the current resources and capacity of New Zealand EDs and explore how these relate to ED performance.

A survey of EDs in New Zealand was conducted to capture elements of governance, staffing and structure of the EDs in the calendar year 2018. These were linked to processes and outcomes of care.

Eighteen of 26 EDs responded. These were representative of the range of EDs nationally. There was wide variability between the EDs across all the surveyed elements. Although no single element was strongly related to performance measures, combinations of elements were. When there was a lack of doctors and available ED or hospital beds relative to the workload, then performance was worse. The correlations were: for time to assessment r=0.728, p=0.001, for ED length of stay r=0.759, p<0.001, for patients who did not wait r=0.619, p=0.006 and for deaths in the ED r=0.649, p=0.004.

There is marked variation among New Zealand hospitals with respect to structure, staffing and workload, which may be impacting negatively on ED performance and limit the ability of some hospitals to cope with surges in demand for acute care.