scholarly journals Quality Improvements in Timeliness to Antibiotics in Solid Organ Malignancy Patients Admitted with Febrile Neutropenia and Neutropenic Sepsis Through the Establishment of an Acute Medical Unit

2022 ◽  
Vol Volume 14 ◽  
pp. 1-8
Author(s):  
Yang Jian Ong ◽  
Nisha Sikotra ◽  
Janelle Prunster ◽  
Nicola Bailey ◽  
Jane Hadfield ◽  
...  
2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 140-140
Author(s):  
Sarb Clare ◽  
Joe Wheeler

2021 ◽  
pp. 201010582110061
Author(s):  
Dayang Nur Hilmiyah binti Awang Husaini ◽  
Justin Fook Siong Keasberry ◽  
Khadizah Haji Abdul Mumin ◽  
Hanif Abdul Rahman

Background: Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance. Objectives: The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei. Methods: A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations. Results: A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%). Conclusions: There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.


2021 ◽  
Vol 41 ◽  
pp. 208-216 ◽  
Author(s):  
Maria Dissing Olesen ◽  
Robert Mariusz Modlinski ◽  
Simon Hosbond Poulsen ◽  
Pernille Mølgaard Rosenvinge ◽  
Henrik Højgaard Rasmussen ◽  
...  

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 44-44
Author(s):  
Dominic Reynish

2000 ◽  
Vol 48 (3) ◽  
pp. 383-407 ◽  
Author(s):  
Joanna Latimer

When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.


2015 ◽  
Vol 44 (suppl 1) ◽  
pp. i7-i7
Author(s):  
R. Keynejad ◽  
A. Hawksley ◽  
J. Harrison ◽  
A. Skinner ◽  
E. Asgari

BMJ ◽  
1975 ◽  
Vol 4 (5991) ◽  
pp. 276-277 ◽  
Author(s):  
S D Horsley ◽  
P J Smail ◽  
A K Thould

QJM ◽  
2021 ◽  
Author(s):  
S J Dauncey ◽  
P A Kelly ◽  
D Baykov ◽  
A C Skeldon ◽  
M B Whyte

Abstract Background The Acute Medical Unit (AMU) provides care for unscheduled hospital admissions. Seven-day Consultant presence and morning AMU discharges have been advocated to improve hospital bed management. Aims To determine whether a later time of daily peak AMU occupancy correlates with measures of hospital stress; whether seven-day Consultant presence, for COVID-19, abolished weekly periodicity of discharges. Design Retrospective cohort analysis Methods Anonymised AMU admission and discharge times were retrieved from the Profile Information Management System (PIMS), at a large, urban hospital from 14th April 2014—31st December 2018 and 20th March—2nd May 2020 (COVID-19 peak). Minute-by-minute admission and discharge times were combined to construct a running total of AMU bed occupancy. Fourier transforms were used to determine periodicity. We tested association between i) average AMU occupancy and ii) time of peak AMU occupancy, with measures of hospital stress (total medical bed occupancy and ‘medical outliers’ on non-medical wards). Results Daily, weekly and seasonal patterns of AMU bed occupancy were evident. Timing of AMU peak occupancy was unrelated to each measure of hospital stress: total medical inpatients (Spearman’s rho, rs=0.04, P = 0.24); number of medical outliers (rs=-0.06, P = 0.05). During COVID-19, daily bed occupancy was similar, with continuation of greater Friday and Monday discharges than the weekend. Conclusions Timing of peak AMU occupancy did not alter with hospital stress. Efforts to increase morning AMU discharges are likely to have little effect on hospital performance. Seven-day Consultant presence did not abolish weekly periodicity of discharges – other factors influence weekend discharges.


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