Admissions

Evaluating acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23)

Performance within acute medicine services is impacted by ongoing pressures on acute care services. Data from the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23), was used to assess performance of acute medicine services compared to key clinical quality indicators, comparing performance by initial assessment location. Data was analysed for 8213 unplanned attendances across 161...

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Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project)

Abstract

Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. This project investigated dermatology assessments by trainees using the Trust’s acute medical admissions proforma. 100 proforma were reviewed for skin assessments alongside nursing skin care bundles. Subsequently, a skin survey was conducted amongst trainees evaluating knowledge and confidence when diagnosing and managing common dermatoses. Successively, a dermatology teaching series was delivered. Post-intervention the above were reassessed, demonstrating  improvements in most areas. The dermatology teaching series will continue alongside a Trust hospital guideline to sustain improvements in dermatological care on admission.

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Tracking the take – Using patient flow data to improve AMU performance and safety

Abstract

Aims: To create a system to co-ordinate the medical take, bed management and track patient flow.
To use the system to continuously audit against Society for Acute Medicine Quality Indicators.
To use the data to model patient flow and optimize working patterns to improve waiting times.

Method: An online whiteboard and underlying database system were designed, tested and implemented.
Data from this system were used to audit against SAM Quality Indicators and then analysed to optimise both trainee and consultant working patterns.

Results: The online whiteboard proved effective and popular as a working tool.
Data collection improved using the electronic system.
Optimising junior doctor working patterns to match demand led to a reduction of average waiting time to see a doctor from 190 minutes to 71 minutes (p < 0.0001), and a reduction in the proportion of patients waiting over 4 hours from 40% to 10% (p < 0.0001). Optimising consultant working patterns did not produced significant changes in waiting times. Conclusions: The online whiteboard improved day-to-day working and data collection, when compared to the previous paper-based system. Better data facilitated analysis of working patterns leading to a significant improvement in patient waiting times.

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