Acute Medicine Units

An Effective System to Measure and Report Quality Indicators in Acute Medical Units

Research Audit and Clinical Practice, Volume 11, Issue 4, Pages 193 - 264 (2012)

Abstract

The Society for Acute Medicine has developed a number of clinical quality indicators by which all UK Acute Medicine Units can bench mark their activity. These will help to ensure high quality care for patients, inform the continuing development of acute medical services and demonstrate the positive impact of this new speciality. Prospective collection of these data may be a challenge for many busy units. This paper describes a local solution developed in house in a North East hospital. It demonstrates how the data collected can be analysed to assess the effect of changes in consultant presence on the unit and also time taken for patients to be seen by a doctor. The limitations of the system and potential for future development are considered.

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Towards ‘Sepsis with Optimal Treatment’: Evaluating the sepsis care pathway in Acute Medicine and identifying scope for systems improvement

Research Audit and Clinical Practice, Volume 12, Issue 1, Pages 1 - 64 (2013)

Abstract

Sepsis commonly presents to the acute medicine unit (AMU). Timely recognition and treatment can reduce the significant associated mortality, but United Kingdom AMUs and emergency departments are often inadequately equipped to manage sepsis with early-goal directed therapy.

We conducted an observational study of 50 consecutive patients admitted with severe sepsis. Demographic, physiological and microbiological data, and information about the provision and timing of care were collected in real time.

Treatment fell below “surviving sepsis” targets with only 28% of patients receiving sufficient fluid, and 64% receiving antibiotics within 3 hours, associated with delays in seeing physicians; however despite this mortality was lower than the nationally quoted average (14% at 90 days).

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