Missed opportunities to use rapid influenza testing and severity assessment to avoid hospital admission: A cohort study from an East London District General Hospital

Author(s):  
Catherine Dominic ◽  
Catherine Welch ◽  
Mark Melzer
Author(s):  
Michael Thurm ◽  
Helen Craggs ◽  
Merlin Watts ◽  
Anthony Brooks

Background The growing number of laboratory investigation requests is placing an increased burden upon NHS resources. Around a quarter of all tests are unnecessary repeats, and almost a third have no impact on patient management. Doctors recognise that tests should only be performed when clinically indicated, but a culture persists of undertaking unnecessary repeat investigations. Methods A cohort study was undertaken at a district general hospital to observe the impact of introducing educational interventions in the form of a poster and a series of educational lectures, encouraging clinicians to consider whether an investigation was clinically indicated. Data was collected from nine different sites across the hospital run by different medical teams regarding the number of tests undertaken and the impact on patient care. Results Data from over 13,000 tests and over 2000 patients was analysed from nine different sites across the hospital. There was a significant reduction (33%, p = 0.0001) in the number of blood tests performed. This reduction in testing saved £7006 over the course of 1 month, in addition to other benefits. There was a reduction in testing in eight out of the nine sites in which the study was undertaken, demonstrating good generalisability of results. There was no significant increase in length of admission or mortality. Conclusion Educational interventions to doctors have a significant and safe impact in reducing the number of unnecessary investigations, providing cost saving benefits to the NHS.


2020 ◽  
Vol 37 (5) ◽  
pp. 164-167
Author(s):  
Aaisha Saqib ◽  
Pratik Solanki ◽  
Matthew Carroll ◽  
Andrew Gough ◽  
Victor Oguntolu

2015 ◽  
Vol 91 (Suppl 1) ◽  
pp. A48.1-A48
Author(s):  
Matthew James ◽  
Eleanor Draeger ◽  
Charles Mazhude ◽  
Ruhin Das ◽  
Melanie Rosenvinge

2009 ◽  
Vol 54 (2) ◽  
pp. 5-8 ◽  
Author(s):  
L Florey ◽  
R Flynn ◽  
C Isles

Objectives To determine whether patients who have used a Scottish district general hospital would prefer single or shared accommodation on a future admission. Methods We surveyed 80 in-patients in January 2008 in order to obtain 20 medical and 20 surgical patients in single rooms and the same number in shared accommodation. Each patient received a seven point questionnaire that had been validated in another centre. Results Forty four men and 36 women, median 64 years, who had been in hospital for a median of 4.5 days (range 1 to 53 days) participated in the survey. Seventy per cent of patients in shared and 40% of patients in single rooms said they would prefer shared accommodation during a future hospital admission. Those expressing a preference for shared accommodation were older (median age 68 versus 58 years) and had been in hospital for longer (median 5.5 versus 3.5 days) than those who said they would prefer a single room. Conclusions It is likely that the desire for company among older people who have to spend a week or more in hospital is driving the responses we obtained. Our findings do not support claims that the argument in favour of 100% single rooms is ‘overwhelming’.


2015 ◽  
Vol 206 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Tom C. Russ ◽  
Mario A. Parra ◽  
Alison E. Lim ◽  
Emma Law ◽  
Peter J. Connelly ◽  
...  

BackgroundPeople with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible.AimsTo identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study.MethodA cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50–94), with a mean follow-up period of 1.2 years.ResultsIn the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08–1.36) was identified as an independent predictor of admission to hospital.ConclusionsNeuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals.


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