scholarly journals P21 Development of a COVID-19 virtual ward to facilitate early discharge from hospital for patients with an on-going oxygen requirement

2021 ◽  
Author(s):  
LA Boast ◽  
GE Lowrey ◽  
RE Aldridge ◽  
K Hall ◽  
R Evans ◽  
...  
Keyword(s):  
Early Discharge ◽  
Oxygen Requirement ◽  
Discharge From Hospital

Early discharge from hospital after open appendicectomy

1993 ◽  
Vol 80 (9) ◽  
pp. 1192-1193 ◽  
Author(s):  
S. Ramesh ◽  
R. B. Galland
Keyword(s):  
Early Discharge ◽  
Open Appendicectomy ◽  
Discharge From Hospital

Post acute care: Can hospitals do better with less?

1997 ◽  
Vol 20 (2) ◽  
pp. 43 ◽  
Author(s):  
Gideon A Caplan ◽  
Ann Brown
Keyword(s):  
Cost Effectiveness ◽  
Length Of Stay ◽  
Acute Care ◽  
Early Discharge ◽  
Government Funding ◽  
Discharge From Hospital ◽  
Post Acute Care

Judging by reports in medical magazines and journals, ?early discharge schemes?, bettertermed ?post acute care?, are not popular with doctors. However, government policyencourages earlier discharge from hospital, so that the choice facing clinicians is todischarge patients early with support, or early without support, or deal with theconsequences of length of stay overruns. Fortunately, government funding for post acutecare is increasing. There is a strong rationale for post acute care based on better patientoutcomes and cost-effectiveness, but these desirable results will only be achieved ifscrupulous attention is paid to detail, as embodied in the 10 principles of post acutecare. To function optimally, post acute care should be coordinated by the hospitalwhich provided the acute care.

Antibiotic management and early discharge from hospital

2011 ◽  
Vol 63 (6) ◽  
pp. e24
Author(s):  
Matthew Dryden ◽  
Kordo Saeed ◽  
Robert Townsend ◽  
Chris Winnard ◽  
Sarah Bourne ◽  
...  
Keyword(s):  
Early Discharge ◽  
Antibiotic Management ◽  
Discharge From Hospital

scholarly journals An inquiry into the incidence of cross-infections, complications and return cases in scarlet fever

1947 ◽  
Vol 45 (3) ◽  
pp. 251-264
Author(s):  
D. G. ff. Edward ◽  
Nuala Crowley ◽  
Elizabeth Topley ◽  
B. Moore
Keyword(s):  
Scarlet Fever ◽  
Average Length ◽  
Early Discharge ◽  
Cross Infection ◽  
Fever Hospital ◽  
Upper Respiratory Tract ◽  
Streptococcal Infections ◽  
Case Rate ◽  
Discharge From Hospital ◽  
Nose And Throat

A simultaneous investigation into certain epidemiological aspects of scarlet fever was carried out over a 2-year period at Oxford, Cambridge and Cardiff. The results obtained at the three centres are compared and contrasted.Nose and throat swabs were taken from 648 patients on admission to hospital; group A haemolytic streptococci were demonstrated in the swabs of 75·3 %. Eight days after admission 81·9 % had given positive swabs.Serological typing showed that 56·9 % of strains were types 1–4. The only other common types were types 11 and 8/25.The average length of stay in hospital was estimated for all cases, divided into groups according to whether or not they had suffered from complications or been cross-infected. The average for the whole series was 30·6 days; this was increased to 33·4 days for all complicated cases and to 37·6 days for all those cross-infected. It was longest (42·3 days) when there were both complications and cross-infections.The incidence of cross-infection with fresh serological types of haemolytic streptococci was noted both in hospital and for the first 3 weeks after discharge. In the whole series 20·1 % of cases were cross-infected in hospital. The cross-infection rate was highest at Cardiff (27·9 %) and lowest at Oxford (13·5 %). Of the 123 cross-infected cases, complications occurred in 23·6%.A total of ninety-eight patients (16·4 %) suffered from complications; in twenty-three of these (23·4%) complications were attributed to cross-infecting strains.Nose and throat swabs were taken from all patients shortly before discharge; 60·3% were still carrying haemolytic streptococci.Data were obtained regarding the rate at which cases became free of haemolytic streptococci. By the 10th week of the disease only 3·2 % of those who had not been cross-infected were carrying streptococci. Cross-infected patients were slower in becoming negative; at the 10th week 25·8% were still carriers.There were fourteen return cases (return case rate 2·1%) following the return home of eleven primary cases (infecting case rate 1·7 %).Swabbing of home contacts at the time of the patient's admission to hospital showed that one or more contacts of 25·5% of cases carried in their naso-pharynx the same type of haemolytic streptococci as that infecting the patient; 12·8% of the contacts swabbed were positive. During the first 3 weeks after discharge 24·6 % of contacts, that is one or more contacts of 55·5% of cases, carried a type that had been harboured by the patient while in hospital.It was noted that in a particular area the common types that gave rise to scarlet fever also commonly caused other streptococcal infections of the upper respiratory tract. Type 12, however, though frequently found in other streptococcal infections and in healthy carriers, appeared only rarely to cause scarlet fever.It is suggested that the low incidence of complications, less intimate relationship between complications and cross-infections and low return case rate found in this investigation, as compared to earlier observations made in England, are associated with lowered virulence and invasive powers of the strains of Str. pyogenes responsible for the much milder scarlet fever now prevalent.The bacteriological findings confirm the wisdom of modern fever hospital practice of early discharge from hospital. It is suggested that discharge within 3 weeks should be the universally adopted rule.

scholarly journals Introducing Vernakalant into Clinical Practice

2019 ◽  
Vol 8 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Angela JM Hall ◽  
Andrew RJ Mitchell
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Sinus Rhythm ◽  
Antiarrhythmic Drug ◽  
Real World ◽  
Early Discharge ◽  
Recent Onset ◽  
Pharmacological Cardioversion ◽  
Discharge From Hospital ◽  
Short Time

Vernakalant is an antiarrhythmic drug licensed for the pharmacological cardioversion of recent onset AF. Randomised clinical trials, backed up by real-world experience, have confirmed its efficacy at restoring sinus rhythm. Vernakalant can be administered simply with a short time to action, facilitating early discharge from hospital in selected patients in place of electrical cardioversion. The authors explore the data behind vernakalant and discuss how it can be introduced into clinical practice.

scholarly journals Cord blood bilirubin used as an early predictor of hyperbilirubinemia

2018 ◽  
Vol 5 (4) ◽  
pp. 1280
Author(s):  
Kannan Ramamoorthy ◽  
M. S. Abilash
Keyword(s):  
Positive Predictive Value ◽  
Cord Blood ◽  
Negative Predictive Value ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Medical College ◽  
Discharge From Hospital ◽  
Early Predictor

Background: Neonatal hyperbilirubinemia is among the commonest symptoms found in neonates. The information about risk of high bilirubin in infants allows simpler methods for reduction of bilirubin to be implemented before hyperbilirubinemia becomes significant and could help to take a decision for early discharge from Hospital. Thus, the authors were aimed at the assessment of the usefulness of the cord blood bilirubin as an early predictor of neonatal hyperbilirubinemia and the usefulness of 1st day bilirubin in predicting the neonatal hyperbilirubinemia.Methods: The present study was planned to conduct in Department of Pediatrics, Government Thiruvarur Medical College and Hospital, Thiruvarur among neonates delivered from 1st August 2011 to 1st December 2013. These neonates were followed from birth to 2nd postnatal day. Cord blood was collected at birth and bilirubin estimation was done within 12 hours of collection of the blood.Results: Cord blood bilirubin level of ≥2.15 mg/dl has a sensitivity of 73.08% and specificity of 59.49%, positive predictive value 14.6% and negative predictive value of 95.88% in predicting the risk of neonatal hyperbilirubinemia. 1st day bilirubin level of ≥5 mg/dl has a sensitivity of 92.3% and specificity of 71.16% and positive predictive value of 23.3% and negative predictive value of 98.9% in predicting the risk of neonatal hyperbilirubinemia.Conclusions: The use of the critical cord bilirubin level of 2 mg/dl in all healthy term newborns will predict significant hyperbilirubinemia.

scholarly journals The impact of post-hospital remote monitoring of COVID-19 patients using pulse oximetry: a national observational study using hospital activity data

2022 ◽  
Author(s):  
Theo Georghiou ◽  
Chris Sherlaw-Johnson ◽  
Efthalia Massou ◽  
Stephen Morris ◽  
Nadia E Crellin ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Hospital Admissions ◽  
Local Level ◽  
Research Programme ◽  
Early Discharge ◽  
Hospital Data ◽  
Activity Data ◽  
Discharge From Hospital ◽  
The Impact ◽  
Roll Out

Background There was a national roll out of "COVID Virtual Wards" (CVW) during England's second COVID-19 wave (Autumn 2020 - Spring 2021). These services used remote pulse oximetry monitoring for COVID-19 patients following discharge from hospital. A key aim was to enable rapid detection of patient deterioration. It was anticipated that the services would support early discharge and avoid readmissions, reducing pressure on beds. This study is an evaluation of the impact of the CVW services on hospital activity. Methods Using retrospective patient-level hospital admissions data, we built multivariate models to analyse the relationship between the implementation of CVW services and hospital activity outcomes: length of COVID-19 related stays and subsequent COVID-19 readmissions within 28 days. We used data from more than 98% of recorded COVID-19 hospital stays in England, where the patient was discharged alive between mid-August 2020 and late February 2021. Findings We found a longer length of stay for COVID-19 patients discharged from hospitals where a CVW was available, when compared to patients discharged from hospitals where there was no CVW (adjusted IRR 1.05, 95% CI 1.01 to 1.09). We found no evidence of a relationship between the availability of CVW and subsequent rates of readmission for COVID-19 (adjusted OR 0.95, 95% CI 0.89 to 1.02). Interpretation We found no evidence of early discharges or reduced readmissions associated with the roll out of COVID Virtual Wards across England. Our analysis made pragmatic use of national-scale hospital data, but it is possible that a lack of specific data (for example, on which patients were enrolled) may have meant that true impacts, especially at a local level, were not ultimately discernible. Funding This is independent research funded by the National Institute for Health Research, Health Services & Delivery Research programme and NHSEI.

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