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Care of patients in corridors of emergency departments is being normalised in many hospitals across the United Kingdom. Clinicians within Emergency Medicine and Acute Medicine have been discussing the impact of this care on patients, as well as the ‘morale injury’ on the staff looking after them. Whilst the authors of this paper have seen evidence of harm caused by delays of care to patients facing long waits in the emergency department, we believe that this is the first analysis that describes the case mix in a large UK hospital. Care in corridors affected patients with a broad range of conditions; 16% had a NEWS of 5 or more, 67% were elderly patients with markers of frailty, and 42% had a history of mental health problems or substance abuse. Full Text File size: 351 KB Downloads: 705...
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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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