Target driven excuses

doi:10.1136/bmj.a1255

Published 11 August 2008, doi:10.1136/bmj.a1255
Cite this as: BMJ 2008;337:a1255

Letters

Target driven care

Target driven excuses

The first 150 words of the full text of this article appear below.

Rawlinson blames the four hour accident and emergency targetfor mismanagement of emergency patients.¹ However, the exampleshe gives of last minute inappropriate moves are merely thoseof poor practice and gaming—what we in the emergency careteam used to call "hitting the target but missing the point."Although I have seen examples of similar behaviour, I have onlyrarely seen it as a result of poor resources these days: ashe says, the target did lead to an increase in staffing andattention from trust management on the standards of emergencycare. The implication that those patients have all been havingactive care or assessment that has added value to their careup to that time, and that would add even more if they couldjust be kept (waiting) in the emergency department even longeris facile: usually they are lying or sitting around becauseof poor systems. The . . . [Full text of this article]