Improving continuity of care in an acute medical unit: initial outcomes

QJM : Monthly Journal of the Association of Physicians
Victoria J St NobleDerek Bell

Abstract

The importance of acute medical units and their associated medical cover is stressed in current practice but there is a paucity of existing research to establish their impact on acute patient care. To assess the impact of a new medical admission process and associated medical cover on patient length of stay (LOS), direct discharge rates (DDR) (for admissions <24 and 48 h), daily discharge and readmission rates (RR). We performed a retrospective analysis of 3163 medical patients admitted before and after a ward was reconfigured to function as an acute medical unit (AMU), with a new on-call rota: 'consultant of the day' changing to 'consultant of the weekend', with aligned junior medical cover. All medical admissions were analysed over three 2-month periods: two periods prior to the new AMU process (October to November, 2005 and June to July, 2006), and one period after the changes (October to Nov, 2006) which were made in August 2006. Average LOS was reduced from 8.6 and 9.3 for the two previous periods (June to July, 2006 and October to November, 2005) to 7.8 days for October to November, 2006, (P = 0.028). DDR for patients with a LOS under 24 and 48 h increased from 21.3% and 31.2% to 28.5% and 39.5%, respectively for both 24 ...Continue Reading

References

Sep 8, 2001·The New England Journal of Medicine·C M Bell, D A Redelmeier
Jul 28, 2004·The American Journal of Medicine·Peter CramGary E Rosenthal
Aug 28, 2004·Hospital Medicine·Carol Black
Mar 12, 2005·QJM : Monthly Journal of the Association of Physicians·E D MoloneyB Silke
Nov 2, 2005·Journal of Health Services Research & Policy·Bryan CurtisBrendan Barrett
Jan 18, 2006·Clinical Medicine : Journal of the Royal College of Physicians of London·L SchmulewitzD Bell

❮ Previous
Next ❯

Citations

Oct 2, 2013·QJM : Monthly Journal of the Association of Physicians·R ConwayB Silke
Oct 30, 2012·Clinical Medicine : Journal of the Royal College of Physicians of London·Les AlaNia Rathbone
Jul 20, 2011·European Journal of Internal Medicine·Declan Byrne, Bernard Silke
Jul 20, 2011·European Journal of Internal Medicine·C P SubbeD Bell
May 8, 2015·Journal of General Internal Medicine·Saul BleckerMarc N Gourevitch
Aug 15, 2014·The British Journal of Surgery·C F H EijsvoogelN W L Schep
May 25, 2016·Health Care Management Science·Amin Mahmoudian-Dehkordi, Somayeh Sadat
Jun 18, 2016·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Lindsay E M ReidNazir I Lone
Nov 12, 2009·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Ian ScottDerek Bell
Feb 1, 2016·Future Hospital Journal·Mike Jones
May 27, 2020·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Chia-Yu ChiuDasol Kang
Mar 20, 2018·Irish Journal of Medical Science·Richard ConwayBernard Silke
Apr 10, 2009·British Journal of Hospital Medicine·Alice Miller, Kate Evans
Nov 17, 2009·The Medical Journal of Australia·E Haydn Walters, David J Dawson
Apr 7, 2010·The Medical Journal of Australia·Jordan Y Z LiCampbell H Thompson
Aug 12, 2021·Clinical Medicine : Journal of the Royal College of Physicians of London·John Ty SoongDerek Bell

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Clinical Medicine : Journal of the Royal College of Physicians of London
Mary Armitage, Tanzeem Raza
QJM : Monthly Journal of the Association of Physicians
C P SubbeL Gemmel
© 2022 Meta ULC. All rights reserved