Targeted improvements

Decreasing accident and emergency target breaches

Healthcare, Hospital Performance

New industry regulations can present opportunities to reassess performance and set more ambitious business goals.

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The Department of Health established the four-hour accident and emergency (A&E) target to help curb wait times for those patients seeking emergency care. In its efforts to meet this target and avoid potential fines, a healthcare provider’s legal group sought to understand and optimise performance against the A&E target.

Insight and Action

The healthcare provider brought in QuantumBlack to help identify new ways to boost performance and meet the guidelines. We started by combining data from more than 12 systems, including patient-level activity, test results, general practitioner (GP) provisions, and bed management. We aimed to track patients through the emergency pathway, from the initial interaction with a GP to urgent care centre and A&E to wards and patient discharge. Our work focused on one of the worst-performing A&E units in the United Kingdom that required the greatest amount work to meet the target.

We identified a number of areas of opportunity for improvement and helped lead the hospital in optimising the transfer of patients, repurposing beds, and adjusting elective procedures. Through our analysis, we were also able to identify congestion in diagnostic testing as a leading indicator of admissions breaches. After this successful pilot, we rolled our process out regionally.


  • 15Percentimprovement in breaches of the four-hour A&E target
  • 25Percentfewer A&E target breaches when a senior band 7 nurse is present in A&E