A comparative analysis of emergency department key performance indicators across Australia: Metrics over meaning?

The adoption of key performance indicators (KPIs) in healthcare has transcended fiscal objectives, now seen as a symbol of commitment to high quality and safe patient care. Our objective was to describe and compare Australian Government state and territory-based Emergency Department (ED) KPIs.

Summative content analysis of all Australian Government state and territory health performance frameworks for 2024-2025 and supplementary documents describing ED KPIs.

ED KPIs varied widely in number and categories across Australia. The proportion of patients seen on time was the only KPI used across all jurisdictions. All jurisdictions aside from Western Australia used ED length of stay as a KPI. Ambulance offload time was used in four jurisdictions. Only Tasmania measured 'did not wait' and only South Australia measured unplanned reattendance as a KPI. Both New South Wales and Tasmania used ED specific patient experience measures in their KPIs. KPIs measuring safety were reported across all jurisdictions but were not specific for ED. There were no KPIs measuring quality standards.

Wide variability in ED KPIs and types of measures limit the ability to benchmark ED care nationally. This variability is shared internationally. It is important that policy makers, clinicians and the public also remain vigilant of the limitations of current KPIs and what they measure.