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Journal articles on the topic 'Acute medical admissions ; Patient journey ; Patient discharge'

Author: Grafiati

Published: 4 June 2021

Last updated: 14 February 2022

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1

Pinkney, Jonathan, Susanna Rance, Jonathan Benger, et al. "How can frontline expertise and new models of care best contribute to safely reducing avoidable acute admissions? A mixed-methods study of four acute hospitals." Health Services and Delivery Research 4, no. 3 (2016): 1–202. http://dx.doi.org/10.3310/hsdr04030.

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BackgroundHospital emergency admissions have risen annually, exacerbating pressures on emergency departments (EDs) and acute medical units. These pressures have an adverse impact on patient experience and potentially lead to suboptimal clinical decision-making. In response, a variety of innovations have been developed, but whether or not these reduce inappropriate admissions or improve patient and clinician experience is largely unknown.AimsTo investigate the interplay of service factors influencing decision-making about emergency admissions, and to understand how the medical assessment proces

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Rycroft, W., and B. Madi. "41 A New Ambulatory Frailty Pathway at Barnsley Hospital." Age and Ageing 50, Supplement_1 (2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.02.

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Abstract Topic At Barnsley Hospital we targeted an improvement in the care of frail patients. The first objective was to improve the patient journey by reducing the amount of time that frail patients spend in busy acute environments. The second objective was to deliver more effective Comprehensive Geriatric Assessment which is recognised as gold standard management (Ellis, G. BMJ 2011;343:d6553). Intervention A new frailty chaired area was opened in July 2018 with capacity to receive up to 6 patients per day from acute admission areas and aim for same day discharge. We developed our own bespok

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Saxton, N., and D. Mayne. "43 Renewing the Frailty Experience: Bringing CGA Into the Emergency Department." Age and Ageing 50, Supplement_1 (2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.04.

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Abstract Topic Early recognition and multidisciplinary management of frail patients in acute care is a national priority. This is reflected in the NHS 10 year plan, NHS Improvement (NHSI) and Getting It Right First Time (GIRFT) ambitions for acute care. The Sunderland Royal Hospital acute frailty service currently reviews frail patients on the Medical Admissions Unit (MAU) each morning. Analysis of our emergency department (ED) data demonstrates that most frail patients arrive to the ED between 12 pm and 18 pm leading to a cohort of frail patients who are not receiving comprehensive geriatric

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Wu, Jane, Olivia Misa, Christine T. Shiner, and Steven G. Faux. "Targeted rehabilitation may improve patient flow and outcomes: development and implementation of a novel Proactive Rehabilitation Screening (PReS) service." BMJ Open Quality 10, no. 1 (2021): e001267. http://dx.doi.org/10.1136/bmjoq-2020-001267.

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Rehabilitation programmes can be delivered to patients receiving acute care (‘in-reach rehabilitation’) and/or those who have completed acute care but experience ongoing functional impairments (‘subacute rehabilitation’). Access to these programmes depends on a rehabilitation assessment, but there are concerns that referrals for this assessment are often triggered too late in the acute care journey. We describe a Proactive Rehabilitation Screening (PReS) process designed to systematically screen patients during an acute hospital admission, and identify early those who are likely to require spe

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Oates, A. "524 QUALITY IMPROVEMENT PROJECT: INCORPORATING COMPREHENSIVE GERIATRIC ASSESSMENT INTO COMMUNITY HOSPITAL CLERKING." Age and Ageing 50, Supplement_2 (2021): ii8—ii13. http://dx.doi.org/10.1093/ageing/afab116.14.

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Abstract Elderly patients transferred to community hospitals often have complex medical, social, psychological, functional and pharmacological backgrounds that require careful assessment in order to create and deliver a high quality, patient-centred care plan. Unfortunately, time pressures experienced by staff in acute hospitals can make Comprehensive Geriatric Assessment (CGA) unfeasible for every patient. Moreover, junior members of the medical team may be unsure as to which aspects of a patient’s background and presentation constitute important elements of a CGA. Failure to recognise and do

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Lovell, Ben, and Timothy Cooksley. "Editorial Volume 17 Issue 4 – Assessing, treating and prognosticating from the front door." Acute Medicine Journal 17, no. 4 (2018): 174–76. http://dx.doi.org/10.52964/amja.0727.

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In our daily working lives, acute physicians strive to provide the best holistic care to our patients from the moment they arrive in hospital. Experienced healthcare professionals develop a gut feeling (generally recognised as the nagging internal voice of professional experience) about patients who may be more unwell than appearances suggest, or who may deteriorate despite showing signs of physiologically compensating quite well. The papers in this issue challenge us to examine how we prioritise, prognosticate and risk-stratify the patients we treat in acute medicine, how we remain cognisant

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Prato, Laura, Lyndsay Lindley, Miriam Boyles, Louise Robinson, and Clare Abley. "Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment." Dementia 18, no. 7-8 (2018): 2710–30. http://dx.doi.org/10.1177/1471301218755878.

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It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study (‘Improving hospital care for adults with cognitive impairment’) aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collect

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Zingela, Zukiswa, Louise Stroud, Johan Cronje, Max Fink, and Stephanus van Wyk. "Protocol for a prospective descriptive prevalence study of catatonia in an acute mental health unit in urban South Africa." BMJ Open 10, no. 11 (2020): e040176. http://dx.doi.org/10.1136/bmjopen-2020-040176.

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IntroductionCatatonia arises from serious mental, medical, neurological or toxic conditions. The prevalence range depends on the setting and the range is anything from 7% to 63% in other countries. South African prevalence rates are currently unknown. The proposed study is a quantitative descriptive study using the Bush Francis Catatonia Screening Instrument as a screening tool with a data capturing information sheet to extract clinical information from patient folders. The study will investigate: (1) prevalence of catatonia, (2) clinical and demographic correlates associated with catatonia, (

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Ribbink, Marthe E., Janet L. Macneil-Vroomen, Rosanne van Seben, Irène Oudejans, and Bianca M. Buurman. "Investigating the effectiveness of care delivery at an acute geriatric community hospital for older adults in the Netherlands: a protocol for a prospective controlled observational study." BMJ Open 10, no. 3 (2020): e033802. http://dx.doi.org/10.1136/bmjopen-2019-033802.

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IntroductionHospital admission in older adults with multiple chronic conditions is associated with unwanted outcomes like readmission, institutionalisation, functional decline and mortality. Providing acute care in the community and integrating effective components of care models might lead to a reduction in negative outcomes. Recently, the first geriatrician-led Acute Geriatric Community Hospital (AGCH) was introduced in the Netherlands. Care at the AGCH is focused on the treatment of acute diseases, comprehensive geriatric assessment, setting patient-led goals, early rehabilitation and strea

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O’Dell, Thomas, Anjali Zalin, and Louella Vaughan. "The Challenges of Conducting Research on the Acute Medical Unit." Acute Medicine Journal 15, no. 4 (2016): 212–14. http://dx.doi.org/10.52964/amja.0639.

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Conducting research on the Acute Medical Unit (AMU) poses unique challenges; the environment is one that sees a diverse range of patient groups and pathologies and holds the potential for easy patient recruitment to research studies, however is geared towards a specific set of triage and discharge goals. We conducted a study into Stress Hyperglycaemia (SH) on a busy AMU, which involved profiling glycaemic changes using specialist equipment and interventions in patients with unscheduled medical admissions, and experienced a number of challenges. This article discusses these challenges and propo

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Roberts, Debra E., Robert G. Holloway, and Benjamin P. George. "Post-acute care discharge delays for neurology inpatients." Neurology: Clinical Practice 8, no. 4 (2018): 302–10. http://dx.doi.org/10.1212/cpj.0000000000000492.

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BackgroundHospital stays for patients discharged to post-acute care are longer and more costly than routine discharges. Issues disrupting patient flow from hospital to post-acute care facilities are an underrecognized strain on hospital resources. We sought to quantify the burden of medically unnecessary hospital days for inpatients with neurologic illness and planned discharge to post-acute care facilities.MethodsWe conducted a retrospective evaluation of hospital discharge delays for patients with neurologic disease and plans for discharge to post-acute care. We identified 100 sequential hos

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Lamsal, Daya Ram. "Acute Pesticide Poisoning: Review of Patients Attending at Emergency Department in Chitwan Medical College." Journal of Chitwan Medical College 3, no. 1 (2013): 62–64. http://dx.doi.org/10.3126/jcmc.v3i1.8469.

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To find out the hospital based incidence, pattern and fatality of acute pesticide poisoning which may be helpful to develop better management strategy and preventive campaign. A total of 88 patients were reported in emergency with acute pesticide poisoning out of 178 total acute poisoning cases resulting in APP rate 49.43% of total poisoning cases. Male: Female ratio was 1:1.5. The age group specific incidence of acute poisoning showed 7.95% in 0-14 years, 45.55% in 15-29 years 30.68% in 30-44 years and 12.50% in 45-59 years and3.40% in 60 years and above. Out of 88 patients 79.55% admitted,20

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Andraweera, Nalinda, and Richard Seemann. "Acute rehospitalisation during the first 3 months of in-patient rehabilitation for traumatic brain injury." Australian Health Review 40, no. 1 (2016): 114. http://dx.doi.org/10.1071/ah15062.

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Objective Unplanned re-admission to acute care hospitals during in-patient rehabilitation causes disruption to the rehabilitation program and increases the cost of health care. The aims of the present study were to identify the frequency, reasons and duration of disruption to rehabilitation because of acute re-admissions during the first 3 months of in-patient rehabilitation for traumatic brain injury (TBI) and to investigate the correlation between the duration of acute rehospitalisation and the discharge functional independence measure (FIM) score. Methods A retrospective study was conducted

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O'Brien, Lauri, Jane Bassham, and Melissa Lewis. "Whiteboards and discharge traffic lights: visual management in acute care." Australian Health Review 39, no. 2 (2015): 160. http://dx.doi.org/10.1071/ah14131.

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Flinders Medical Centre was experiencing issues with timely discharge and knowing the potential discharges and in-patient bed capacity for the next day. This case study describes the application of ‘visual management’ theory to discharge processes. The solutions developed were ‘patient journey boards’ and ‘discharge traffic lights’. The implementation of these visual management systems has enabled the hospital to improve its discharge processes. What is known about the topic? Communication is critical to the delivery of safe patient care. There is little in the literature on the use of visual

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Dixon, Mandy, Emma Robertson, Mohan George, and Femi Oyebode. "Risk factors for acute psychiatric readmission." Psychiatric Bulletin 21, no. 10 (1997): 600–603. http://dx.doi.org/10.1192/pb.21.10.600.

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A retrospective case note study explored readmissions to an acute psychiatric in-patient unit within six months of discharge. The study aimed to calculate a hospital readmission rate, to investigate the timing of readmissions, and to identify risk factors associated with readmission. The readmission rate was 27% with the majority of readmissions occurring within three months after discharge, suggesting the need for investigation of such early readmissions. The three factors found to predict readmission were: discharge against medical advice, number of previous admissions, and living alone or w

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Muir, A., and S. Paul. "An audit of medical and nursing records of 100 emergency short-term (< 7 dys) psychiatric admissions to acute adult wards in Dumfries." European Psychiatry 26, S2 (2011): 748. http://dx.doi.org/10.1016/s0924-9338(11)72453-1.

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IntroductionThe study population is served by CMHTs and in addition (in one sector) by a Crisis and Home Treatment Team.ObjectivesTo evaluate the recorded admission and discharge processes in the medical and nursing notes.To record relevant clinical characteristics of the admission and the patient.AimsTo assess recorded admission and discharge processes against standards defined in the protocol.MethodsA random sample of 100 records, which met inclusion criteria, was selected. A protocol evaluating the recorded processes, and relevant information re the admission was completed by psychiatric tr

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Peterson, Lance R., Marc O. Wright, Jennifer L. Beaumont, et al. "Nonimpact of Decolonization as an Adjunctive Measure to Contact Precautions for the Control of Methicillin-Resistant Staphylococcus aureus Transmission in Acute Care." Antimicrobial Agents and Chemotherapy 60, no. 1 (2015): 99–104. http://dx.doi.org/10.1128/aac.02046-15.

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ABSTRACTThis was an observational study comparing methicillin-resistantStaphylococcus aureus(MRSA) transmission with no decolonization of medical patients to required decolonization of all MRSA carriers during two consecutive periods: baseline with no decolonization of medical patients (16 months) and universal MRSA carrier decolonization (13 months). The setting was a one-hospital, 156-bed facility with 9,200 annual admissions. Regression models were used to compare rates of MRSA acquisition. The chi-square test was used to compare event frequencies. We used rates of MRSA clinical disease as

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Hammond, Drayton A., Melanie N. Smith, Kristen C. Lee, Danielle Honein, and April Miller Quidley. "Acute Decompensated Heart Failure." Journal of Intensive Care Medicine 33, no. 8 (2016): 456–66. http://dx.doi.org/10.1177/0885066616669494.

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Heart failure (HF) is a societal burden due to its high prevalence, frequent admissions for acute decompensated heart failure (ADHF), and the economic impact of direct and indirect costs associated with HF and ADHF. Common etiologies of ADHF include medication and diet noncompliance, arrhythmias, deterioration in renal function, poorly controlled hypertension, myocardial infarction, and infections. Appropriate medical management of ADHF in patients is guided by the identification of signs and symptoms of fluid overload or low cardiac output and utilization of evidence-based practices. In patie

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Brand, Caroline A., Catherine T. Jones, Adrian J. Lowe, et al. "A transitional care service for elderly chronic disease patients at risk of readmission." Australian Health Review 28, no. 3 (2004): 275. http://dx.doi.org/10.1071/ah040275.

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Background: Multiple hospital admissions, especially those related to chronic disease, represent a particular challenge to the acute health care sector in Australia. Objective: To determine whether a nurse-led chronic disease management model of transitional care reduced re admissions to acute care. Design: A quasi-experimental controlled trial. Setting: A large tertiary metropolitan teaching hospital. Participants: 166 general medical patients aged >65 years with either a history of re admissions to acute care or multiple medical comorbidities. Intervention: Implementation of a chronic dis

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Roseveare, Chris. "Editorial Volume 15 Issue 3." Acute Medicine Journal 15, no. 3 (2016): 110. http://dx.doi.org/10.52964/amja.0619.

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Acute Medicine is full of ‘C-words’ – the Nursing and Midwifery Council’s ‘Six Cs’ (Care, Compassion, Competence, Commitment, Courage and Competence) are as relevant on the AMU as anywhere else in the Health Service; acute physicians would probably also include co-ordination, collaboration and crisis management, as winter looms before us. Dan Beckett’s paper from Forth Valley in Scotland, suggests another word that should be added to the list. As we strive to design sustainable rotas which span 7 days and comply with European work-time directives it is understandable that continuity often fall

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Kafle, Dilli Ram, and Surendra Shah. "Outcome of Patients with Gullain Barre syndrome at Tertiary Care Hospital in Eastern Nepal." Journal of Nobel Medical College 6, no. 2 (2018): 20–24. http://dx.doi.org/10.3126/jonmc.v6i2.19565.

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Background: Gullain Barre syndrome is the most common cause of acute flaccid paralysis. Early diagnosis and treatment improves survival in patients with Gullain Barre Syndrome.Material and Methods: The purpose of the study was to note the common clinical features and identify predictors of outcome in Patients with Gullain Barre Syndrome. It is a prospective study which was conducted at Nobel Medical College Teaching Hospital from April 2015 to March 2016.Results: Time between onset of symptoms, presentation to hospital and admission was 5 ± 4 days. Four Patients (20%) gave history of upper res

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Randles, Mary, Sylvia Hickey, Susanne Cotter, et al. "144 The Use of a Multidisciplinary Team Discharge “Huddle” to Improve Patient Flow and Planning." Age and Ageing 48, Supplement_3 (2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.30.

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Abstract Background Patient flow, the movement of patients is an integral part of the patient care pathway. With the goal of improving overall patient care and discharge planning, a hospital wide, multidisciplinary team based, patient discharge meeting or ‘HUDDLE’ was devised with the goal of facilitating onward care planning for all inpatients especially those with complex discharge needs in a city centre teaching hospital. Methods The patient flow huddle has evolved to include a Patient Flow Clinical Nurse Manager, Bed Manager, Medicine for Older Persons Clinical Nurse Specialist, Physiother

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Murray, M., P. L. Padfield, and S. R. J. Maxwell. "Does a Hospital Formulary Influence Prescribing Practice in an Acute Medical Admissions Unit?" Scottish Medical Journal 50, no. 2 (2005): 76–79. http://dx.doi.org/10.1177/003693300505000212.

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Aim: To assess the extent to which prescribing of cardiovascular medications in a busy medical unit deviates from the local joint primary and secondary care drug formulary guidelines. Method: A retro spective audit of the case notes, prescription charts and discharge summaries oj 150 randomly selected emergency medical admissions overa 4 month period. Results: No patient receiving a non-formulary cardiovascular drug on admission had the choice reviewed in line with formulary recommendations. One third of new cardiovascular medications commenced in hospital were not compliant with formulary rec

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Lim, H. J., R. Robson, N. Alexander, et al. "100 Frailty Hot Clinics: Rapid Cga and Speciality Diagnostics Reduces Rates of Hospitalisation and Re-Attendance." Age and Ageing 50, Supplement_1 (2021): i12—i42. http://dx.doi.org/10.1093/ageing/afab030.61.

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Abstract Introduction Acute hospitalisation is associated with an increased risk of progressive frailty, morbidity and subsequent institutionalisation. North Middlesex University Hospital is an Acute District General Hospital with over 550 attendances to A&E per day. Comprehensive Geriatric Assessment (CGA) is the gold standard approach for a holistic multi-disciplinary assessment (MDT) of frail patients. A rapid access daily hot clinic service for frail patients opened using quality improvement (QI) methodology to deliver rapid CGA focusing on admission avoidance and early supported disch

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Temple, RM, and A. Donley. "The future hospital – implications for acute care." Acute Medicine Journal 13, no. 1 (2014): 4–5. http://dx.doi.org/10.52964/amja.0330.

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Acute physicians are confronted daily by the relentless increase in clinical demand, inadequate continuity of care, breakdown in out of hours care and a looming crisis in the medical workforce. The scale and gravity of these factors, together with changes to patient’s needs relating to the ageing demography, were detailed in the RCP report published in September 2012 ‘Hospitals on the edge’. The top concern of RCP members and fellows was the lack of continuity of care, ahead of financial pressures and clinical staff shortages. Worryingly one in ten physicians stated they would not recommend th

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Draper, Brian. "The Elderly Admitted to a General Hospital Psychiatry Ward." Australian & New Zealand Journal of Psychiatry 28, no. 2 (1994): 288–97. http://dx.doi.org/10.1080/00048679409075641.

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In this retrospective study of 489 consecutive elderly admissions to a general hospital psychiatry ward, the main aim was to describe the stressors precipitating admission, psychiatric and medical diagnoses, physical treatments used, length of hospitalisation, and clinical and social outcome. Depression was the predominant diagnosis, with length of stay being correlated with depression severity. The main stressor associated with admissions was a change in medical status of the patient. At least two medical diagnoses were present in 70% of admissions, with many new physical illnesses being diag

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Dasta, Joseph F., David A. Kuhl, Olakunbi A. Agiri, and Laurie S. Mauro. "Beta-Agonists in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease." Annals of Pharmacotherapy 28, no. 12 (1994): 1379–88. http://dx.doi.org/10.1177/106002809402801209.

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OBJECTIVE: To critically evaluate the following issues regarding the use of beta-agonists in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD): (1) optimal dose, (2) use of nebulizer (NEB) versus metered-dose inhaler-spacer devices (MDISs), (3) comparison with anticholinergic agents, and (4) use in mechanically ventilated patients. The patient populations addressed are limited primarily to emergency department (ED) and intensive care/acute care settings. DATA SOURCES: English-language journal articles published between 1977 and 1993. STUDY SELECTION: Nine stu

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Al-Bazz, Dalal, Fareeba Anwar, and Qaiser Javed. "Utilisation of mental health transfer checklist proforma from acute physical health hospitals (Liverpool University Hospitals NHS Foundation Trust) to mental health hospitals (Mersey Care NHS Foundation Trust)." BJPsych Open 7, S1 (2021): S307. http://dx.doi.org/10.1192/bjo.2021.812.

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AimsTesting the compliance and completion rate of a transfer checklist (proforma) created in accordance with local hospital policies.BackgroundThe proforma was developed following serious incidents where medically unstable patients were inappropriately discharged to mental health hospitals, requiring readmission to acute medical hospitals. Frequently these events reported an inadequate handover from medical to mental health teams and patients were often prematurely deemed medically fit with evidence to the contrary.Although parity of esteem between mental and physical health has been a high pr

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Wilding, Daniel, and Kate Evans. "Predicting length of stay for acute medical admissions using the ALICE score: a simple bedside tool." Acute Medicine Journal 16, no. 2 (2017): 60–64. http://dx.doi.org/10.52964/amja.0656.

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Background: Early identification of patients likely to have a short admission permits best use of limited resources to facilitate rapid discharge where possible. The ALICE score is a simple bedside tool developed in one hospital as a decision aid. This study sought to confirm its widespread applicability. Method: Retrospective review of 250 consecutive admissions at five acute hospitals. Clinical records were reviewed for a total of 1003 patients. ALICE score was calculated for each patient and compared to LoS data. Results: There was a statistically significant positive correlation between ri

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Hossain, Mohd Farid, Sailendra Nath Biswas, Masudur Rahman, Tanvir Ahmed, and Apu Karmaker. "Laparoscopic Cholecystectomy in Patients with Emphysematous and Gangrenous Cholecystitis: An Experience at Khwaja Yunus Ali Medical College & Hospital, Enayetpur, Sirajgonj." KYAMC Journal 5, no. 2 (2017): 519–23. http://dx.doi.org/10.3329/kyamcj.v5i2.32366.

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Objective- To look for the feasibility and safety of laparoscopic cholecystectomy in patients with emphysematous and gangrenous cholecystitis.Back ground- Emphysematous and gangrenous cholecystitis are severe form of acute cholecystitis. They are considered as contraindication of laparoscopic cholecystectomy due to peri operative life threatening complications, surgical technical difficulties, frequent conversion to open procedure. This study describe our experience in terms of feasibility and safety with laparoscopic cholecystectomy in patients with emphysematous and gangrenous cholecystitis.

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Hasan, Md Mahboob, MA Baqui, Farzana Rahman, and Merajul Hasan. "Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia." Journal of Armed Forces Medical College, Bangladesh 15, no. 1 (2020): 119–20. http://dx.doi.org/10.3329/jafmc.v15i1.48662.

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A 33 years old patient was admitted in a Military Hospital with the features of acute large gut obstruction. Exploratory laparotomy was done and peroperatively the obstruction was seen in the transverse colon and obstruction seemed to be carcinoma of transverse colon with involvement of left hemidiaphragm which was not negotiable. Transverse loop colostomy with decompression of bowel was done. Subsequently the patient was transferred to tertiary level hospital in Dhaka. In the tertiary hospital, the patient developed left sided massive pleural effusion. With relevant investigation the conditio

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Shammas, Nicolas W., Ryan Kelly, Jon Lemke, et al. "Assessment of Time to Hospital Encounter after an Initial Hospitalization for Heart Failure: Results from a Tertiary Medical Center." Cardiology Research and Practice 2018 (2018): 1–4. http://dx.doi.org/10.1155/2018/6087367.

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Background. Hospital inpatient readmissions for patients admitted initially with the primary diagnosis of heart failure (HF) can be as high as 20–25% within 30 days of discharge. This, however, does not include admissions for observations or emergency department (ED) visits within the same time frame and does not show a time-dependent hospital encounter following discharge after an index admission. We present data on time-dependent hospital encounter of HF patients discharged after an index admission for a primary diagnosis of HF. Methods. The study recruited patients from 2 hospitals within t

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Waters, Ruairí, Robert Murphy, Edel Mannion, et al. "280 Acute Hospital Presentations among Nursing Home Residents: A Retrospective Observational Analysis." Age and Ageing 48, Supplement_3 (2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.63.

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Abstract Background Nursing home residents are prone to acute illness due to their advancing age, underlying illnesses and immobility. The decision to refer a nursing home resident for acute hospital admission is a complex one, and there is no consensus among health care professionals about what constitutes an ‘appropriate admission’ to hospital from a nursing home. We aimed to explore patterns of acute nursing home patient presentations to the emergency department. Methods This was a retrospective cohort study of emergency hospital admissions to a tertiary university teaching hospital. Emerge

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Mahmood, Nazneen, Md Fazlur Rahman, Md Mostafizur Rahman, SM Hossain Shahid, and Md Mahmudur Ahman Siddiqui. "Acute Kidney Injury in Patients of Intensive Care Unit." Anwer Khan Modern Medical College Journal 8, no. 1 (2017): 38–44. http://dx.doi.org/10.3329/akmmcj.v8i1.31656.

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Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney

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Roseveare, Chris. "Editorial." Acute Medicine Journal 14, no. 1 (2015): 2. http://dx.doi.org/10.52964/amja.0403.

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The use of early warning scores to monitor the condition of patients has been one of the biggest changes in hospital practice over the past decade. This journal has featured many papers evaluating different scoring systems for medical patients admitted to hospital in an emergency; as the mechanisms for measuring, recording and calculating these scores become more refined our ability to predict which patients will deteriorate and require higher dependency care has continued to improve. In this edition, a paper from Canada has highlighted the key importance of one component of most scoring syste

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Abuzied, Yacoub, Hassan Maymani, Basim AlMatouq, and Oweida AlDosary. "Reducing the Length of Stay by Enhancing the Patient Discharge Process: Using Quality Improvement Tools to Optimize Hospital Efficiency." Global Journal on Quality and Safety in Healthcare 4, no. 1 (2021): 44–49. http://dx.doi.org/10.36401/jqsh-20-27.

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ABSTRACT Introduction Delays in the discharging process can affect hospital efficiency. Improving patient flow in acute care hospitals is an essential issue that hospital management and research aim to achieve. Admission volume and LOS for hospitalized patients in the medical specialties department was examined at a tertiary care center in Riyadh, Saudi Arabia, to explore practical approaches to reduce the LOS. We aimed to identify and manage reasons for the delay in discharging patients from the medical specialties department at a tertiary care center in Saudi Arabia. Methods Admission and di

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Arani, Nitkunan, Macdonald Bridget, Bhoodoo Ajay, et al. "THUR 021 Transforming acute neurology: a 4 year study." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 10 (2018): A4.1—A4. http://dx.doi.org/10.1136/jnnp-2018-abn.13.

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We present a novel approach to acute neurological care. The key is an acute neurology triage nurse, based in the medical admission unit as well as an epilepsy specialist nurse seeing every patient referred with fits on the day of admission, a designated acute neurology consultant and acute neurophysiology and neuroradiology links. We have designated this group, a hyperacute neurology team (HANT).This study compares all admissions in 2014, the year before the team was established with 2015–2017. The total number of referrals has increased from 720 in 2014 to 1248 in 2017. The percent of patient

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Lovell, Ben. "Editorial Volume 18 Issue 4 – Decision-making in acute medicine." Acute Medicine Journal 18, no. 4 (2019): 206–7. http://dx.doi.org/10.52964/amja.0777.

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Acute physicians make patient-centred decisions at the start of the patient’s hospital journey. Dozens more decisions are made by the individual members of the MDT (and, of course, by the patient) during the in-patient period. Decisions are made at every level of seniority and experience and range widely in scope and impact. The original articles in this issue are connected by a common thread: phenomena that inform and influence the decisions made by acute physicians. How do you obtain adequate data to make sound decisions about individual patient care? It is often necessary to collate data ar

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Tung, J., K. Decaria, D. Dudgeon, et al. "Acute-Care Hospital Use Patterns Near End-of-Life for Cancer Patients Who Die in Hospital in Canada." Journal of Global Oncology 4, Supplement 2 (2018): 109s. http://dx.doi.org/10.1200/jgo.18.13800.

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Background: Acute-care hospitals have a role in managing the needs of people with cancer when they are at the end-of-life; however, overutilization of hospital care at the end-of-life results in poorer quality of life and can worsen the patient's experience. Early integration of comprehensive palliative care can greatly reduce unplanned visits to the emergency department, reduce avoidable admissions to hospital, shorten hospital stays, and increase the number of home deaths as well as improve the quality of life of patients with advanced cancer. Aim: To describe the current landscape of acute-

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Mylotte, Joseph M., Robin Graham, Lucinda Kahler, B. Lauren Young, and Susan Goodnough. "Impact of Nosocomial Infection on Length of Stay and Functional Improvement Among Patients Admitted to an Acute Rehabilitation Unit." Infection Control & Hospital Epidemiology 22, no. 02 (2001): 83–87. http://dx.doi.org/10.1086/501868.

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AbstractObjective:To identify factors predictive of length of stay (LOS) and the level of functional improvement achieved among patients admitted to an acute rehabilitation unit for the first time, with special reference to the role of nosocomial infection.Setting:A 40-bed acute rehabilitation unit within a 300-bed, tertiary-care, public, university-affiliated hospital.Study Population:All patients admitted to the unit between January 1997 and July 1998.Design:Prospective cohort study in which demographic and clinical data, including occurrence of nosocomial infection, were collected during th

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Vescovo, Mariavittoria. "Consensus document ANMCO/FADOI/SIAARTI/SIC/SIMG/SIMI/SIMEU: The clinical-diagnostic and therapeutic pathway of patients with acute heart failure in the Emergency Department." Italian Journal of Medicine 13, no. 4 (2019): 247–76. http://dx.doi.org/10.4081/itjm.2019.1230.

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Acute heart failure (HF) involves hospitals throughout the world and, as well as other acute cardiac pathologies such as coronary syndromes, has markedly unfavorable outcomes: the mortality or rehospitalization rate after 3 months is 33%, mortality 1 year after admission varies between 25% and 50%. A critical factor in managing acute HF is the multiplicity of health professionals involved in the diagnostic-therapeutic pathway of this syndrome - general practitioners, emergency doctors, cardiologists, internists, anesthesiologists/resuscitators - and therefore also the need to integrate d

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O'Donovan, Claire, Steve Wright, Simon Towler, and Erin Furness. "56 Streamlining Referral Processes at a Tertiary Acute Medical Ambulatory Centre." Age and Ageing 48, Supplement_3 (2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.32.

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Abstract Background The Acute Medical Ambulatory Centre (AMAC) was established with the goals of facilitating early discharge and preventing avoidable medical admissions. 12 months post its introduction, the service was inefficient and operating under capacity. A project aimed to improve the AMAC referral processes and increase the centre’s overall efficiency was undertaken. Methods Western Australia Department of Health Clinical Service Redesign methodology (a blend of Lean and Six Sigma methodologies) was used to complete the project. This involved process mapping, root cause analysis and so

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Triplett, Katherine Elizabeth, Andrew Ford, and Matthew Anstey. "Psychiatric symptoms post intensive care unit admission." BMJ Case Reports 12, no. 12 (2019): e231917. http://dx.doi.org/10.1136/bcr-2019-231917.

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A 53-year-old woman was admitted to a tertiary intensive care unit (ICU) with acute respiratory distress syndrome secondary to severe community-acquired pneumonia that necessitated maximum supportive care with venovenous extracorporeal membrane oxygenation. Her medical history included bipolar disorder on quetiapine and sertraline, as well as a previous ICU admission, approximately 2 years prior, for non-cirrhotic hyperammonaemic encephalopathy that was complicated by prolonged post discharge anxiety and post-traumatic stress disorder-like symptoms, consistent with post-intensive-care syndrome

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Sullivan, Clair, Andrew Staib, Rob Eley, et al. "Who is less likely to die in association with improved National Emergency Access Target (NEAT) compliance for emergency admissions in a tertiary referral hospital?" Australian Health Review 40, no. 2 (2016): 149. http://dx.doi.org/10.1071/ah14242.

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Objective The aim of the present study was to identify patient and non-patient factors associated with reduced mortality among patients admitted from the emergency department (ED) to in-patient wards in a major tertiary hospital that had previously reported a near halving in mortality in association with a doubling in National Emergency Access Target (NEAT) compliance over a 2-year period from 2012 to 2014. Methods We retrospectively analysed routinely collected data from the Emergency Department Information System (EDIS) and hospital discharge abstracts on all emergency admissions during cale

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Cader, Fathima Aaysha, M. Maksumul Haq, Sahela Nasrin, and CM Shaheen Kabir. "Presentation, Management Practices and In-hospital Outcomes of Patients with Acute Coronary Syndrome in a Tertiary Cardiac Centre in Bangladesh." Bangladesh Heart Journal 32, no. 2 (2018): 106–13. http://dx.doi.org/10.3329/bhj.v32i2.36097.

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Background: There is no large-scale data on the management practices and in-hospital outcomes of acute coronary syndromes (ACS) in Bangladesh. This study aimed to document the presentation characteristics, treatment practices and in-hospital outcomes of ACS patients presenting to a specialized tertiary cardiac care institute in Bangladesh.Methods: This retrospective observational study included all ACS patients presenting to Ibrahim Cardiac Hospital & Research Institute (ICHRI), Dhaka, Bangladesh, over the period of January 2013 to December 2013. Data were collected from hospital discharge

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Busingye, Doreen, Monique F. Kilkenny, Tara Purvis, et al. "Is length of time in a stroke unit associated with better outcomes for patients with stroke in Australia? An observational study." BMJ Open 8, no. 11 (2018): e022536. http://dx.doi.org/10.1136/bmjopen-2018-022536.

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ObjectiveSpending at least 90% of hospital admission in a stroke unit (SU) is a recommended indicator of receiving high-quality stroke care. However, whether this makes a difference to patient outcomes is unknown. We aimed to investigate outcomes and factors associated with patients with acute stroke spending at least 90% of their admission in an SU, compared with those having less time in the SU.DesignObservational study using cross-sectional data.SettingData from hospitals which participated in the 2015 Stroke Foundation National Audit: Acute Services (Australia) and had an SU. This audit in

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Einsiedel, Lloyd J., Eileen van Iersel, Robert Macnamara, et al. "Self-discharge by adult Aboriginal patients at Alice Springs Hospital, Central Australia: insights from a prospective cohort study." Australian Health Review 37, no. 2 (2013): 239. http://dx.doi.org/10.1071/ah11087.

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Objective. To determine rates and risk factors for self-discharge by Aboriginal medical inpatients at Alice Springs Hospital. Methods. Prospective cohort study. Interviews were conducted in primary language by Aboriginal Liaison Officers, from July 2006 to August 2007. Topics included understanding of diagnosis, satisfaction with services and perceptions of staff and environment. Risk factors for self-discharge were then determined prospectively. Results. During the study period 202 (14.7%) of 1380 patients admitted to general medical units at Alice Springs Hospital, were interviewed. Self-dis

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Kim, Roger Y., Xiaopan Yao, Peter Longley, Joan Rimar, Chryssanthi Kournioti, and Alfred Ian Lee. "Using the Rothman Index to Predict Discharge and Readmission Rates in an Inpatient Hematology Unit." Blood 124, no. 21 (2014): 1302. http://dx.doi.org/10.1182/blood.v124.21.1302.1302.

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Abstract BACKGROUND: Limited data exists regarding predictors of discharge (DC) disposition and readmission (RA) rates for hematology-oncology patients who are hospitalized. The Rothman Index (RI) is a single numerical score ranging from -91 to 100 derived from 26 data elements including vital signs, laboratory results, and nursing assessments. It is automatically calculated and displayed in real-time in the electronic medical record by a commercial software system. A previous analysis at our institution revealed a significant association between RI and DC disposition, and between RI and RA ra

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Hull, Russell, Duane Bates, Cynthia Brocklebank, Nelly Komari, and Tazmin Merali. "Rate of Late Venous Thromboembolism Events In High-Risk Medical Patients." Blood 116, no. 21 (2010): 82. http://dx.doi.org/10.1182/blood.v116.21.82.82.

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Abstract Abstract 82 Background: Current guidelines recommend that venous thromboembolism (VTE) prophylaxis should be given to high-risk medical inpatients based on evidence of reduced VTE events and reduced mortality. However, current guidelines do not specify the appropriate length of VTE prophylaxis in this population, especially after discharge. The EXCLAIM study showed a 90 day VTE incidence of 4.2% in those patients who received enoxaparin for 10 days in the hospital, with 1.1% being symptomatic VTE. However, real world data is needed to understand the risk of VTE for this patient popula

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Rudilosso, Salvatore, Carlos Laredo, Víctor Vera, et al. "Acute Stroke Care Is at Risk in the Era of COVID-19." Stroke 51, no. 7 (2020): 1991–95. http://dx.doi.org/10.1161/strokeaha.120.030329.

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Background and Purpose: The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center. Methods: On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes

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