Pathology processes and emergency department length of stay: the impact of change

In reply: A recent report on the state of Australian public hospitals highlights figures of 320.6 emergency presentations per 1000 weighted population, with 88% of presentations being triage categories 1–4, and 66% of patients not admitted.1 In our experience, pathology tests are performed on more than 50% of patients in these triage categories who present to emergency departments, and decisions regarding patient care are delayed pending availability of test results. In addition to the initiatives that we described,2 Georgiou and Westbrook describe other initiatives that deliver significant, sustained improvements in health care efficiency.