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Emergency Medicine Journal 2007;24:402-404; doi:10.1136/emj.2006.044933
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

ORIGINAL ARTICLE

The "4-hour target": emergency nurses’ views

Andy Mortimore1, Simon Cooper2

1 Emergency Department, Torbay Hospital, Lawes Bridge, Torquay, Devon, UK
2 Faculty of Health and Social Work, University of Plymouth, Plymouth, Devon, UK

Correspondence to:
Correspondence to:
Charge Nurse Andy Mortimore
Emergency Department, Torbay Hospital, Lawes Bridge, Torquay, Devon, TQ2 7AA, UK; andy.mortimore{at}nhs.net

Objective: To explore nurses’ views and to identify the perceived advantages and disadvantages of the "4-hour target"

Methods: The study was based in one emergency department (ED) in the UK and took a generic qualitative approach. A stratified sample of nine experienced ED nurses were recruited for semi-structured interviews. Data was analysed using the framework analysis1,2 approach.

Results: The 4-hour target was considered an overall success in reducing waiting times and increasing patient satisfaction. However, staff expressed concerns over the imposed nature of the target, workload pressures, quality of care, and the level of support from secondary and primary care.

Conclusion: Although deemed an overall success, there were reservations as to the target’s sustainability. Recommendations are made for improved communication between primary and secondary care and establishing the target as a shared goal within the hospital environment.

Abbreviations: BMA, British Medical Association; DH, Department of Health; ED, emergency department; GP, general practitioner

Keywords: emergency; targets; waiting times; patient satisfaction; quality; communication


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