All Journals from David Ward
Abstract
Specialist trainees in Acute Medicine have expressed concerns over skills training in the curriculum, compared with skills training in practice. Thus, an online survey was conducted in 2009 to investigate these comments in detail. The responses from 132 trainees were analysed. The results show that the majority of practical skills are being performed by trainees who feel that they have reached a level of competence sufficient to enable them to teach the skill to others. The major causes for concern were highlighted as temporary cardiac pacing, endotracheal intubation and Sengstaken Blakemore tubes. We recommend that these skills should be taught via simulation where not available in practice, but true competence cannot be expected for the majority.
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Abstract
Background: NHS London released commissioning standards for Adult emergency services in September 2011. The Pan-London Acute Medicine Network (PLAN) agreed to survey its members regarding these standards.
Method: A web-based survey asked PLAN members to comment on the standards which were most relevant to Consultant-delivered care in Acute Medicine. The self-reported rate of compliance with each standard was calculated. The free text comments were grouped by thematic analysis.
Results: 23 responses were received. The compliance with each standard was variable between 9% and 91%.
Discussion: A series of themes are discussed and presented as tips to be considered by those responsible for providing Consultant-delivered care to patients on an AMU.
Conclusion: There is still enormous variation between trusts in how acute medical services are supported by Consultant physicians. The demands on each service and the resources available to trusts differ hugely, therefore the solutions to providing a Consultant-led service need to be tailor made for each AMU.
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Abstract
Introduction:The Society for Acute Medicine Benchmarking Audit (SAMBA) is an annual national audit in the UK.
Methods:In SAMBA 2015 patient feedback questionnaires were introduced to help measure the quality of patient experience on Acute Medical Units (AMUs) over a 24-hour period on 25th June 2015.
Results: 55 AMUs submitted data on 945 patients, of these 824 (87.2%) would be extremely likely or likely to recommend the AMU. Patients below the age of 50 were less likely to recommend the admitting unit (p<0.013). Positive comments were three times more common than critical comments (976 vs 323). Categories of staff attitude, quality of communication, timeliness of care and catering were dominant themes. Conclusion:This survey has identified key themes for patients being managed on an AMU that can be used to guide future innovations.
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Abstract
Background: Benchmarking is important to improve quality of care.
Aim: To audit the performance of Acute Medical Units (AMUs) against the clinical quality indicators published by the Society for Acute Medicine (SAM).
Methods: 24-hour data collection on the 20th of June 2013 with follow-up data at 72 hours.
Results: 43 units submitted data on 1425 patients. 76% of patients had early warning scores recorded within 30 minutes of admission, 95% of patients had been seen by a competent decision maker within four hours. 79% of patients were seen by a consultant physicians within the appropriate period of time.
Conclusion: The difference in compliance with quality standards between UK units opens opportunities for learning. The reasons why some units perform better than others require further investigation.
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