All Journals from M Holland
For those of you who are not aware of what GIRFT (Getting It Right First Time) is, let me start by saying it is a brilliant idea, genius perhaps. The vision of its founder, Professor Tim Briggs CBE, was to optimise orthopaedic care by using the most clinically and cost effective treatments, minimising waste, reducing variation and eliminating poor practice. Since 2014 in orthopaedics alone, operational and financial opportunities to save the NHS £696 million have been generated. Acute medicine, coupled with general medicine, has been part of the GIRFT programme since 2017. The mischievous reader might question the name, as clearly this is about getting things right at the second time of asking at the very earliest. Apart from that pedantic note, GIRFT is a force for good.
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Acute Medicine is a specialty that is not defined by a single organ system and sits at the interface between primary and secondary care. In order to document improvements in the quality of care delivered a system of metrics is required.
A number of frameworks for measurements exist to quantify quality of care at the level of patients, teams and organisations, such as measures of population health, patient satisfaction and cost per patient. Measures can capture whether care is safe, effective, patient-centred, timely, efficient and equitable. Measurement in Acute Medicine is challenged by the often-transient nature of the contact between Acute Medicine clinicians and patients, the lack of diagnostic labels, a low degree of standardisation and difficulties in capturing the patient experience in the context.
In a time of increasing ecological and financial constraints, reflecting about the most appropriate metrics to document the impact of Acute Medicine is required.
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