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Showing results for tags 'Admission'.
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Content ArticleOver the past 12 years, the number of emergency hospital admissions in England has increased by 42%, from 4.25 million in 2006/07 to 6.02 million in 2017/18. Over 60% of patients admitted to hospital as an emergency have one or more long-term health conditions such as asthma, diabetes or mental illness. Patients with long-term conditions spend under 1% of their time in contact with health professionals. The majority of their care, such as monitoring their symptoms and administering medication and treatment, comprises tasks they or their carers manage on a daily basis. To find out how able patients currently feel to manage their health conditions, the Health Foundation looked at Patient Activation Measure (PAM) scores, which assess four levels of knowledge, skill and confidence in self-management, for over 9,000 adults with long-term conditions. In this briefing, the Health Foundation assesses the evidence for the effectiveness of a range of approaches the NHS could use more often to support patients to manage their health conditions. These include: health coaching, self-management support through apps, social prescribing initiatives and peer support including via online communities.
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Content ArticleThis study from Harris et al. estimated the effect of prompt admission to critical care on mortality for deteriorating ward patients. They found that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.
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Content ArticleEmergency Department *ED) crowding has potential detrimental consequences for both patient care and staff. Advancing disposition can reduce crowding. This may be achieved by using prediction models for admission. This systematic review from Brink et al. aims to present an overview of prediction models for admission at the ED. Furthermore, we aimed to identify the best prediction tool based on its performance, validation, calibration and clinical usability.
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Content ArticleThis study from Baseggio Conrado et al. describe time trends for hospital admissions due to food anaphylaxis in the United Kingdom over the past 20 years. The authors found that hospital admissions for food induced anaphylaxis have increased from 1998 to 2018, however the case fatality rate has decreased. In school aged children, cow’s milk is now the most common single cause of fatal anaphylaxis.
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Content ArticleNew research by the Health Foundation shows that the amount of hospital care received by those living in care homes in England rapidly declined in the first three months of the pandemic in 2020 and was substantially lower than in the same period in 2019. The research, which is due to be peer reviewed, provides the first comprehensive and national analysis of all hospital care provided to care home residents during the first wave of the pandemic. It appears to substantiate concerns that care home residents (including those in nursing homes and residential care) may have faced barriers to accessing hospital treatment as the NHS rapidly reorganised to free up hospital capacity to care for critically ill COVID-19 patients.
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Content ArticleDelays to timely admission from emergency departments (EDs) are known to harm patients. In this study, Jones et al. assessed and quantified the increased risk of death resulting from delays to inpatient admission from EDs, using Hospital Episode Statistics and Office of National Statistics data in England.
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Content ArticleThis study in BMJ Quality & Safety aimed to determine whether areas with higher levels of socioeconomic deprivation or larger ethnic minority populations saw larger falls in emergency and planned admissions in England during the Covid-19 pandemic. The study found that Covid-19 did not have an evenly spread impact on NHS hospital care for non-Covid patients, with disparities corresponding to deprivation and ethnicity. Although it is hard to determine the mechanisms behind these differences, the authors argue that they could make pre-pandemic health inequalities worse.
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Content ArticleAll health overuse implies an unnecessary risk of patients suffering adverse events (AEs). However, this hypothesis has not been corroborated by direct estimates for inappropriate hospital admission (IHA). The objectives of the study were (1) to analyse the association between IHA and the development of subsequent AEs; and (2) to explore the distinct clinical and economic implications of AEs subsequent IHA compared to appropriate admissions. It found that patients with IHA have a higher risk of subsequent occurrence of AE. Due to the multifactorial nature of AEs, IHA is a possible contributing factor. AEs developed after IHA are associated with scheduled admissions, prolonged ICU stays, and resulted in significant cost overruns.
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Content ArticleSuccessful day surgery requires a day surgery team with the correct knowledge and skills to enable safe, early recovery and discharge but there is an absence of national guidance on supporting competencies. Applying in-patient competency criteria is inappropriate as this pathway is not aimed at promoting early discharge. This joint publication between AfPP and BADS (the British Association Of Day Surgery) provides recommendations for core competencies for adult day surgery through (1) admission, (2) anaesthetic room, (3) theatres, (4) first-stage recovery and (5) second-stage recovery and discharge. They are relevant for staff new to or after a long absence from day surgery and acknowledge some members of the day surgery team may include non-registered practitioners. All can be used as a reference for workbook competency documents in place or in development.
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Content ArticleOver the two decades before the pandemic, the number of NHS patients admitted to hospital increased year-on-year, despite a reduction in the number of hospital beds. Since the Covid-19 pandemic, fewer patients have been admitted to NHS hospitals and length of stay has risen, raising questions about NHS productivity, quality of care and the prospects of meeting ambitions to recover services. This report by the Health Foundation analyses data around hospital admissions and suggests reasons for these trends.
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Content ArticleHospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
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News Article
Doctors warn hospitals ‘not coping’ as study links A&E waits to deaths
Patient Safety Learning posted a news article in News
Hospitals are not able to cope with current pressures, senior doctors have warned, as a new study links long A&E waits to an increased risk of death. Patients waiting more than five hours within an emergency department are at an increased risk of dying, according to a study published in the Emergency Medicine Journal (EMJ). The study’s findings come as emergency care performance across England continues to deteriorate, and as pressures across hospitals mean that more patients are waiting for more than four hours in A&E departments than ever before. According to the research, death rates for patients waiting between six and eight hours before admission to hospital were 8% higher, and they were 10% higher for those waiting eight to 12 hours. The study was based on data collected prior to the pandemic, and national A&E waiting times have since deteriorated further. In November last year, the Royal College of Emergency Medicine (RCEM) warned that long delays and overcrowding in A&Es may have caused thousands of deaths during the pandemic. Researchers said that although cause and effect could not be established between longer waits and deaths after 30 days of hospital admission, they recognised a statistically significant trend. The paper said: “Long stays in the emergency department are associated with exit block and crowding, which can delay access to vital treatments. And they are associated with an increase in subsequent hospital length of stay, especially for older patients. Read full story Source: The Independent, 19 January 2022 -
News ArticleFailings by NHS 111 contributed to the death of an autistic teenager, a coroner has ruled. Hannah Royle, 16, suffered a cardiac arrest as she was driven to hospital by her parents after a 111 algorithm failed to notice she was seriously ill. A coroner said her death had exposed a risk people were being misled about the capability of the system and its staff. An NHS spokesperson said it would act on the findings and learnings "where necessary". Hannah's father Jeff Royle said he regretted dialling 111 and wished he had taken his daughter straight to hospital. "I feel so dreadful, that I have let her down and she has been let down by the NHS," he said. Read full story Source: BBC News, 20 October 2021
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News Article
Liverpool intensive care units '90% full' as city braces for second wave
Patient Safety Learning posted a news article in News
Intensive care units in Liverpool’s hospitals are more than 90% full, according to a local health leader, as the city braces for a second wave of COVID-19 infections. Councillor Paul Brant, cabinet member for adult health and social care at Liverpool City Council, warned that hospital services were once again being forced to care for patients critically ill with coronavirus. "Our intensive, critical care beds are filling up very fast,” he told BBC Radio 4's Today programme. "The most recent figures I've seen suggest they are over 90 per cent full and our acute hospital trusts have occupancy levels of Covid-positive patients of over 250. At the current rate of increase, we would expect Liverpool to surpass the peak of the first wave probably within the next seven to 10 days." Addressing the intensive care situation, he added: "They are not all Covid patients, I should say, but they are running very full and they are running with an increasing number of people who are Covid-positive." He added: "It has become clear that the intensity of the demand on hospital services here in Liverpool is crowding out anything other than dealing with Covid." Read full story Source: The Independent, 14 October 2020 -
News ArticleThe number of people being admitted to hospital with COVID-19 is rising in some regions but "few, if any" are from care homes, according to an NHS leader. Younger people are making up most of coronavirus hospital admissions, with 70% of admissions in one hospital consisting of under-45s, NHS Providers chief executive Chris Hopson said. Although the number of hospital admissions is "ticking up" in areas most affected by the Indian Covid variant, the rise is small compared with the levels seen earlier in the year. Speaking to Times Radio, Mr Hopson said most hospitalisations were among younger people and those who have been offered the vaccine but have yet to take up the offer. A number are among those who have only had their first dose of a COVID-19 vaccine, while “a very small number” are fully vaccinated with both doses. Read full story Source: The Independent, 26 May 2021
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EventUnsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. WHO Patient Safety Flagship has initiated a series of monthly webinars on the topic of “WHO Global Patient Safety Challenge: Medication Without Harm”,. The main objective of the webinar series is support implementation of this WHO Global Patient Safety Challenge: Medication Without Harm at the country level. Considering the huge burden of medication-related harm, Medication Safety has also been selected as the theme for World Patient Safety Day 2022. With each transition of care (as patients move between health providers and settings), patients are vulnerable to changes, including changes in their healthcare team, health status, and medications. Discrepancies and miscommunication are common and lead to serious medication errors, especially during hospital admission and discharge. Countries and organizations need to optimise patient safety as patients navigate the healthcare system by setting long-term leadership commitment, defining goals to improve medication safety at transition points of care, developing a strategic plan with short- and long-term objectives, and establishing structures to ensure goals are achieved. At this webinar, you will be introduced to the WHO technical report on “Medication Safety in Transitions of Care,” including the key strategies for improving medication safety during transitions of care. Register
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Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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Content ArticleIt is 20 years since researchers discovered that patients admitted to hospitals on Saturdays or Sundays are more likely to die than those admitted Monday to Friday. The ‘weekend effect’ was assumed to be because fewer hospital specialists work at weekends, meaning care was less good. However, there was no evidence to support this assumption. This NIHR Alert is based on: This NIHR Alert is based on: Bion J, and others. Increasing specialist intensity at weekends to improve outcomes for patients undergoing emergency hospital admission: the HiSLAC two-phase mixed-methods study. Health Services and Delivery Research 2021;9:13.
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Content ArticleReducing hospital bed days is currently the ultimate currency in healthcare. Large amounts of money seem to increasingly be diverted from tried and tested workforces into new services, new jobs, and new technology in order to prevent patients being admitted to hospital. Some of these new ideas could work well, while others have the potential to be a catastrophe, but what unites them all is a focus on a single outcome: saving bed days in the acute hospital. But The NHS's single minded pursuit of admission avoidance risks ignoring other important outcomes, writes Alison Leary in this BMJ opinion piece.
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Content ArticleDr Hein Le Roux is Primary Care Patient Safety GP Lead at the West of England Academic Health Science Network. Here Hein interviews Dr Emma Redfern on their programme to encourage the use of the National Early Warning Score (NEWS), followed by a conversation with Dr Sheena Yerburgh on a standardised admission sheet they have helped to develop, which is being used by GPs in the Gloucestershire area when referring patients to emergency departments.
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Content ArticleThis pneumonic is for quick diagnosis / risk assess for coronavirus developed by doctors in Italy.
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Content ArticleThis report published by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) looked to identify and explore remediable factors in the clinical and organisation of the physical healthcare provided to adult patients admitted to a mental health inpatient setting. The report suggests that a physical healthcare plan should be developed when patients are admitted to a mental health inpatient setting. Other key messages aimed at improving care include calls to: formalise clinical networks/pathways between mental health and physical health care; involve patients and their carers in their physical health care, and use admission as an opportunity to assess and involve patients in their general health, and include mental health and physical health conditions on electronic patient records.
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Content ArticleThe VIP scheme is supported by the learning disability liaison team in the acute hospital to improve health outcomes. The scheme promotes reasonable adjustments, person centred surgical care pathways, accessible information and decision making care plans to support those who may lack the capacity to make health decisions. It also includes VIP champions and promotes evidence based training. The scheme is supported by the Wakefield Patient Experience Group, made up of people who have a learning disability. The VIP scheme has improved health outcomes of patients with learning disabilities at Mid-Yorkshire Hospitals Trust. The scheme, all though multi-faceted, has one common aim; achieving equality for patients with a learning disability.
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Content ArticleAn informational video for people being admitted to a ward at the Royal Derby Hospital, designed for our patients with learning disabilities.
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Content ArticleReasonable adjustments to the care of people with learning disabilities who receive hospital care are beneficial for all involved. This article, published in the Nursing Times, uses two case studies to demonstrate their benefits. Author, Linda Phillips, is a learning disability health liaison nurse at Hywel Dda University Health Board.
