首页 > 最新文献

Acute Medicine最新文献

英文 中文
Implementing a Digital Deteriorating Patient Pathway to improve the safety and effectiveness of care of the adult deteriorating patient. 实施 "数字化病情恶化患者路径",提高对病情恶化的成年患者的护理安全性和有效性。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0968
Adrian Jennings, Philip Brammer, Sian Annakin, Helen Bromage, Tom Cook, Michele Hickey, Jagjit Dhami, Fhezan Ashraf, Ravi Sahota-Thandi, Stephen Borrington

Identification, escalation and clinical review of the deteriorating patient is essential for a safe and effective hospital. We present a deteriorating patient pathway developed within our electronic patient record, including implementation of a digital escalation and senior review process, triggered from a logic algorithm and vital signs. The pathway is activated by an average 43 patients per day with median mortality of 13.3%. Our Trust has seen a significant improvement in escalation and senior review and increased use of treatment escalation plans. The pathway has facilitated a cultural shift in the Trust towards the deteriorating patient. The new pathway is transferrable to both other digital Trusts as well as maternity and paediatric practice.

对病情恶化的病人进行识别、升级和临床审查,对医院的安全和效率至关重要。我们介绍了在电子病历中开发的恶化病人路径,包括根据逻辑算法和生命体征触发的数字升级和高级审查流程。平均每天有 43 名患者启动该路径,死亡率中位数为 13.3%。我们的信托基金在升级和高级审查方面取得了重大改进,并增加了治疗升级计划的使用。该路径促进了信托基金对病情恶化病人的文化转变。新路径既可用于其他数字信托机构,也可用于产科和儿科实践。
{"title":"Implementing a Digital Deteriorating Patient Pathway to improve the safety and effectiveness of care of the adult deteriorating patient.","authors":"Adrian Jennings, Philip Brammer, Sian Annakin, Helen Bromage, Tom Cook, Michele Hickey, Jagjit Dhami, Fhezan Ashraf, Ravi Sahota-Thandi, Stephen Borrington","doi":"10.52964/AMJA.0968","DOIUrl":"https://doi.org/10.52964/AMJA.0968","url":null,"abstract":"<p><p>Identification, escalation and clinical review of the deteriorating patient is essential for a safe and effective hospital. We present a deteriorating patient pathway developed within our electronic patient record, including implementation of a digital escalation and senior review process, triggered from a logic algorithm and vital signs. The pathway is activated by an average 43 patients per day with median mortality of 13.3%. Our Trust has seen a significant improvement in escalation and senior review and increased use of treatment escalation plans. The pathway has facilitated a cultural shift in the Trust towards the deteriorating patient. The new pathway is transferrable to both other digital Trusts as well as maternity and paediatric practice.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating dynamic patterns in mortality before and after reconfiguration of the Danish emergency healthcare system. 评估丹麦急诊医疗系统重组前后死亡率的动态模式。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0967
Marianne Fløjstrup, Anna Kollerup, Søren B Bogh, Mickael Bech, Daniel Henriksen, Søren P Johnsen, Mikkel Brabrand

Background: This study explored changes in short-term mortality during a national reconfiguration of emergency care starting in 2007.

Methods: Unplanned hospital contacts at emergency departments across Denmark from 2007 to 2016. The reconfiguration was a natural experiment, resulting in individual timelines for each hospital. The outcome was in-hospital and 30-day mortality.

Results: Individual patient-level data included 9,745,603 unplanned hospital contacts from 2007 to 2016 at 20 hospitals with emergency departments. We observed a sharp downwards shift in in-hospital mortality and 30-day mortality in three hospitals in relation to the reconfiguration.

Conclusion: This nationwide study identified three hospitals where the reconfiguration was closely associated with reduced in-hospital and 30-day mortality. In contrast, no major effects were identified for the remaining hospitals.

研究背景本研究探讨了自 2007 年开始的全国急诊医疗重组期间短期死亡率的变化:2007年至2016年期间,丹麦各地急诊科的非计划性住院接触。重新配置是一项自然实验,因此每家医院都有各自的时间表。结果为住院和 30 天死亡率:患者个人层面的数据包括 2007 年至 2016 年期间 20 家设有急诊科的医院的 9745603 次计划外医院接触。我们观察到,有三家医院的院内死亡率和 30 天死亡率因重新配置而急剧下降:这项全国性研究发现,有三家医院的重新配置与院内死亡率和 30 天死亡率的降低密切相关。相比之下,其余医院未发现重大影响。
{"title":"Evaluating dynamic patterns in mortality before and after reconfiguration of the Danish emergency healthcare system.","authors":"Marianne Fløjstrup, Anna Kollerup, Søren B Bogh, Mickael Bech, Daniel Henriksen, Søren P Johnsen, Mikkel Brabrand","doi":"10.52964/AMJA.0967","DOIUrl":"https://doi.org/10.52964/AMJA.0967","url":null,"abstract":"<p><strong>Background: </strong>This study explored changes in short-term mortality during a national reconfiguration of emergency care starting in 2007.</p><p><strong>Methods: </strong>Unplanned hospital contacts at emergency departments across Denmark from 2007 to 2016. The reconfiguration was a natural experiment, resulting in individual timelines for each hospital. The outcome was in-hospital and 30-day mortality.</p><p><strong>Results: </strong>Individual patient-level data included 9,745,603 unplanned hospital contacts from 2007 to 2016 at 20 hospitals with emergency departments. We observed a sharp downwards shift in in-hospital mortality and 30-day mortality in three hospitals in relation to the reconfiguration.</p><p><strong>Conclusion: </strong>This nationwide study identified three hospitals where the reconfiguration was closely associated with reduced in-hospital and 30-day mortality. In contrast, no major effects were identified for the remaining hospitals.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency physicians' experiences with defensive medicine and their motives for acting defensively - an interview study. 急诊医生的防御性医疗经验及其采取防御性行动的动机--访谈研究。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0988
Thorbjørn Hougaard Mikkelsen, Mikkel Brabrand, Anne Friesgaard Christensen, Merethe Kousgaard Andersen

Background: Defensive medicine (DM) has been increasingly studied in recent years. This study aims to investigate the understanding of DM and the motives for practicing DM among emergency physicians.

Methods: Focus group interviews.

Results: Themes identified: The understanding of DM, DM is a matter of self-confidence, DM or tests to ensure diagnosis and patient flow, DM due to confounding by availability, DM due to guidelines, Patient-initiated DM, Fear of complaints, DM in an emergency department setting.

Conclusion: This study shows that emergency physicians perform an abundance of diagnostic tests and investigations but only categorize few of them as DM. The many flow-mediating tests based on guidelines may, however, mask activities that individual physicians would possibly find defensive, if it was up to them to decide based on pure and simple anamnesis and clinical findings. It might be argued that flow optimization has overruled medical clinical reasoning in some ways, thereby introducing an inclination to conduct DM.

背景:近年来,对防御性医疗(Defensive Medicine,DM)的研究越来越多。本研究旨在调查急诊科医生对防御医学的理解以及实施防御医学的动机:方法:焦点小组访谈:结果:确定了主题:对 DM 的理解、DM 是自信心的问题、DM 或检查以确保诊断和患者流量、DM 因可用性而混淆、DM 因指南而产生、患者主动 DM、对投诉的恐惧、急诊科环境中的 DM:本研究表明,急诊医生进行了大量的诊断测试和检查,但只有少数测试和检查被归类为 DM。然而,根据指南进行的许多流程中介检查可能会掩盖一些医生可能会认为具有防御性的活动,如果由他们根据纯粹而简单的病史和临床发现来决定的话。可以说,流程优化在某些方面已经压倒了医学临床推理,从而引入了进行 DM 的倾向。
{"title":"Emergency physicians' experiences with defensive medicine and their motives for acting defensively - an interview study.","authors":"Thorbjørn Hougaard Mikkelsen, Mikkel Brabrand, Anne Friesgaard Christensen, Merethe Kousgaard Andersen","doi":"10.52964/AMJA.0988","DOIUrl":"https://doi.org/10.52964/AMJA.0988","url":null,"abstract":"<p><strong>Background: </strong>Defensive medicine (DM) has been increasingly studied in recent years. This study aims to investigate the understanding of DM and the motives for practicing DM among emergency physicians.</p><p><strong>Methods: </strong>Focus group interviews.</p><p><strong>Results: </strong>Themes identified: The understanding of DM, DM is a matter of self-confidence, DM or tests to ensure diagnosis and patient flow, DM due to confounding by availability, DM due to guidelines, Patient-initiated DM, Fear of complaints, DM in an emergency department setting.</p><p><strong>Conclusion: </strong>This study shows that emergency physicians perform an abundance of diagnostic tests and investigations but only categorize few of them as DM. The many flow-mediating tests based on guidelines may, however, mask activities that individual physicians would possibly find defensive, if it was up to them to decide based on pure and simple anamnesis and clinical findings. It might be argued that flow optimization has overruled medical clinical reasoning in some ways, thereby introducing an inclination to conduct DM.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"132-139"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Guest Editorial - Ambulatory Care: Turning Urgent and Emergency Care inside out. 特邀社论--非住院医疗:将急诊和急救护理翻转过来。
Q3 Medicine Pub Date : 2024-01-01
Rosalind Rowland, Daniel Lasserson

Emergency departments are under year-round pressure, driven by high hospital bed occupancy and compounded by increasing attendances and admissions. In 2023, 1.5 million people waited 12 hours or more for a bed. Long waits are associated with increased mortality and there is a disproportionate impact on people living in more deprived areas. Addressing this problem begins with unity of purpose and vision, such that we all view emergency department performance as our responsibility, whatever our place in the healthcare system.

医院病床占用率高,加上就诊人数和入院人数不断增加,急诊科常年承受着巨大压力。2023 年,将有 150 万人等待病床的时间达到或超过 12 小时。漫长的等待与死亡率的上升有关,对生活在贫困地区的人们的影响尤为严重。要解决这一问题,首先要有统一的目标和愿景,无论我们在医疗系统中处于什么位置,都要将急诊科的表现视为我们的责任。
{"title":"Guest Editorial - Ambulatory Care: Turning Urgent and Emergency Care inside out.","authors":"Rosalind Rowland, Daniel Lasserson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Emergency departments are under year-round pressure, driven by high hospital bed occupancy and compounded by increasing attendances and admissions. In 2023, 1.5 million people waited 12 hours or more for a bed. Long waits are associated with increased mortality and there is a disproportionate impact on people living in more deprived areas. Addressing this problem begins with unity of purpose and vision, such that we all view emergency department performance as our responsibility, whatever our place in the healthcare system.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 2","pages":"54-55"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial - Acute Medical Care: "Exit block". 社论--急诊护理:"退出障碍"。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0965
T Cooksley

NHS urgent and emergency care (UEC) remains under immense and unsustainable pressure. This is increasingly causing harm to patients and emotional trauma to the staff striving to deliver basic standards of care.

英国国家医疗服务系统(NHS)的紧急医疗服务(UEC)仍然承受着巨大的、不可持续的压力。这对患者造成的伤害越来越大,对努力提供基本标准医疗服务的工作人员造成的精神创伤也越来越大。
{"title":"Editorial - Acute Medical Care: \"Exit block\".","authors":"T Cooksley","doi":"10.52964/AMJA.0965","DOIUrl":"10.52964/AMJA.0965","url":null,"abstract":"<p><p>NHS urgent and emergency care (UEC) remains under immense and unsustainable pressure. This is increasingly causing harm to patients and emotional trauma to the staff striving to deliver basic standards of care.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 1","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thyrotoxic Periodic Paralysis: A Case Report with Patient Perspective. 甲亢性周期性麻痹:带患者视角的病例报告
Q3 Medicine Pub Date : 2024-01-01
Aliaksandra Baranskaya, Yimeng Zhang, Brian Lee

We present a case report on a spot diagnosis of Thyrotoxic Periodic Paralysis (TPP) with a unique first-person account of events from the patient. It illustrates the importance of pattern recognition and exemplifies how timely treatment enables quick resolution of a life-threatening medical emergency. Patient X's account affirms the condition's insidious onset and rapid deterioration. This case highlights the need for raising awareness of diseases that are more prevalent in specific ethnic groups and is particularly crucial for work in culturally diverse environments. We hope by sharing our experience, readers will be prompted to consider TPP as a differential diagnosis for acute limb weakness in an acute setting; with prompt testing of thyroid function and initiation of the appropriate treatments.

我们提交了一份关于甲状腺毒性周期性麻痹(TPP)现场诊断的病例报告,并以独特的第一人称叙述了患者的病情。它说明了模式识别的重要性,并举例说明了及时治疗如何使危及生命的紧急医疗状况得到迅速解决。患者 X 的叙述证实了病情的隐匿起病和迅速恶化。本病例强调了提高对特定种族群体高发疾病的认识的必要性,这对于在多元文化环境中工作尤为重要。我们希望通过分享我们的经验,能促使读者将 TPP 作为急性期急性肢体无力的鉴别诊断,并及时检测甲状腺功能和采取适当的治疗措施。
{"title":"Thyrotoxic Periodic Paralysis: A Case Report with Patient Perspective.","authors":"Aliaksandra Baranskaya, Yimeng Zhang, Brian Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present a case report on a spot diagnosis of Thyrotoxic Periodic Paralysis (TPP) with a unique first-person account of events from the patient. It illustrates the importance of pattern recognition and exemplifies how timely treatment enables quick resolution of a life-threatening medical emergency. Patient X's account affirms the condition's insidious onset and rapid deterioration. This case highlights the need for raising awareness of diseases that are more prevalent in specific ethnic groups and is particularly crucial for work in culturally diverse environments. We hope by sharing our experience, readers will be prompted to consider TPP as a differential diagnosis for acute limb weakness in an acute setting; with prompt testing of thyroid function and initiation of the appropriate treatments.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 2","pages":"91-94"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Retrospective Comparison of Emergency Department Throughput Before and After Instituting a Waiting Room Evaluation Process. 实施候诊室评估流程前后急诊科吞吐量的回顾性比较。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0987
John Teijido, Benjamin Blackwood, Barry Knapp, Laura Strojny

Background: The COVID-19 pandemic has strained the healthcare system with emergency department (ED) boarding and workforce shortages. This prompted the need for strategies to evaluate and treat patients while they waited for an ED room.

Objectives: The objective is to describe a waiting room evaluation process and ED throughput in the setting of ED staffing shortages and boarding.

Methods: This is a retrospective before and after cohort study evaluating ED throughput before and after initiation of the assessed waiting room (aWR) process. The aWR process is a joint effort by emergency clinicians and ancillary staff to evaluate and treat patients in the ED waiting room when no ED bed is available. Throughput data 6 months before and 6 months after institution of aWR was collected and analyzed.

Results: The arrival to provider time and the number of patients who left without being seen (LWBS) decreased with initiation of the aWR process. The remainder of throughput metrics remained unchanged. There was more ED boarding at Wisconsin sites during the aWR process period.

Conclusions: The aWR process may minimize LWBS and improve arrival to provider time in the setting of staff shortages and more ED boarders. It may help other ED throughput metrics although numerous confounding factors make it difficult to make definitive conclusions. This process may be trialed during times of challenging healthcare landscape, such as pandemic conditions and with workforce shortages.

背景:COVID-19 大流行给医疗系统带来了压力,急诊科 (ED) 人满为患,劳动力短缺。这促使人们需要制定策略,在患者等待急诊室时对其进行评估和治疗:目的:描述在急诊科人员短缺和病人滞留的情况下候诊室评估流程和急诊科吞吐量:这是一项前后回顾性队列研究,评估了评估候诊室(aWR)流程启动前后的急诊室吞吐量。aWR 流程是急诊临床医生和辅助人员在急诊室没有床位的情况下,在急诊室候诊室对患者进行评估和治疗的一项联合工作。我们收集并分析了 aWR 启用前 6 个月和启用后 6 个月的吞吐量数据:结果:随着 aWR 流程的启动,患者到达医疗机构的时间和未就诊即离开的患者人数(LWBS)均有所下降。其余吞吐量指标保持不变。在启用 aWR 流程期间,威斯康星州医疗点的急诊室登机人数有所增加:aWR 流程可最大限度地减少 LWBS,并在人员短缺和急诊室寄宿人数增加的情况下缩短患者到达医疗机构的时间。该流程可能有助于其他急诊室吞吐量指标,但由于混杂因素较多,很难做出明确结论。在医疗保健形势严峻的时期,如大流行病和劳动力短缺的情况下,可以试用该流程。
{"title":"A Retrospective Comparison of Emergency Department Throughput Before and After Instituting a Waiting Room Evaluation Process.","authors":"John Teijido, Benjamin Blackwood, Barry Knapp, Laura Strojny","doi":"10.52964/AMJA.0987","DOIUrl":"https://doi.org/10.52964/AMJA.0987","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has strained the healthcare system with emergency department (ED) boarding and workforce shortages. This prompted the need for strategies to evaluate and treat patients while they waited for an ED room.</p><p><strong>Objectives: </strong>The objective is to describe a waiting room evaluation process and ED throughput in the setting of ED staffing shortages and boarding.</p><p><strong>Methods: </strong>This is a retrospective before and after cohort study evaluating ED throughput before and after initiation of the assessed waiting room (aWR) process. The aWR process is a joint effort by emergency clinicians and ancillary staff to evaluate and treat patients in the ED waiting room when no ED bed is available. Throughput data 6 months before and 6 months after institution of aWR was collected and analyzed.</p><p><strong>Results: </strong>The arrival to provider time and the number of patients who left without being seen (LWBS) decreased with initiation of the aWR process. The remainder of throughput metrics remained unchanged. There was more ED boarding at Wisconsin sites during the aWR process period.</p><p><strong>Conclusions: </strong>The aWR process may minimize LWBS and improve arrival to provider time in the setting of staff shortages and more ED boarders. It may help other ED throughput metrics although numerous confounding factors make it difficult to make definitive conclusions. This process may be trialed during times of challenging healthcare landscape, such as pandemic conditions and with workforce shortages.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research in Acute Medicine. The results of a national survey of Society for Acute Medicine members. 急症医学研究。对急症医学会会员进行的全国性调查的结果。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0985
Suzy Gallier, James Hodson, Kum Loon Kwok, Lily Li, Charlotte Morgan, Benjamin Lewis, C Subbe, E Punj, C Atkin, E Sapey

Background: Medical research improves patient outcomes, patient satisfaction, staff morale and retention. It is unclear what research opportunities and training staff in acute medicine had.

Methods: The Society for Acute Medicine supported a survey to assess current research activity, training and perceived opportunities and barriers.

Results: 292 responses were received from diverse professional backgrounds. Few respondents had formal research qualifications or were undertaking research, but the majority valued research and wanted more research experience including formal training. Barriers included time constraints and perception that research in acute medicine was less valued by healthcare organisations. Preferred mechanisms to increase research included mentorship, advocacy, and increased opportunities.

Conclusions: Strategies to increase research in acute medicine should consider these results in forward planning.

背景:医学研究可改善患者疗效、提高患者满意度、鼓舞员工士气并留住人才。目前还不清楚急症医学科的员工有哪些研究机会和培训:方法:急诊医学会支持了一项调查,以评估当前的研究活动、培训以及感知到的机会和障碍。结果:共收到来自不同专业背景的 292 份回复。很少有受访者拥有正式的研究资格或正在进行研究,但大多数人都重视研究,并希望获得更多研究经验,包括正式培训。障碍包括时间限制以及认为医疗机构不太重视急症医学研究。增加研究的首选机制包括导师制、宣传和增加机会:增加急症医学研究的策略应在前瞻性规划中考虑这些结果。
{"title":"Research in Acute Medicine. The results of a national survey of Society for Acute Medicine members.","authors":"Suzy Gallier, James Hodson, Kum Loon Kwok, Lily Li, Charlotte Morgan, Benjamin Lewis, C Subbe, E Punj, C Atkin, E Sapey","doi":"10.52964/AMJA.0985","DOIUrl":"https://doi.org/10.52964/AMJA.0985","url":null,"abstract":"<p><strong>Background: </strong>Medical research improves patient outcomes, patient satisfaction, staff morale and retention. It is unclear what research opportunities and training staff in acute medicine had.</p><p><strong>Methods: </strong>The Society for Acute Medicine supported a survey to assess current research activity, training and perceived opportunities and barriers.</p><p><strong>Results: </strong>292 responses were received from diverse professional backgrounds. Few respondents had formal research qualifications or were undertaking research, but the majority valued research and wanted more research experience including formal training. Barriers included time constraints and perception that research in acute medicine was less valued by healthcare organisations. Preferred mechanisms to increase research included mentorship, advocacy, and increased opportunities.</p><p><strong>Conclusions: </strong>Strategies to increase research in acute medicine should consider these results in forward planning.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"107-117"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23). 根据评估时间指标评估急症医疗服务绩效:急症医学基准审计学会 2023 (SAMBA23)。
Q3 Medicine Pub Date : 2024-01-01 DOI: 10.52964/AMJA.0984
Catherine Atkin, Chris Subbe, Mark Holland, Ragit Varia, Tim Cooksley, Adnan Gebril, Adrian Kennedy, Thomas Knight, Daniel Lasserson

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 hospitals. Comparing by initial assessment location, performance against the clinical quality indicators was unchanged from 2022. Only 29% of daytime arrivals assessed within the Emergency Department received consultant review within target times. Delays were seen in transfer between acute care locations. 29% of patients requiring admission were not admitted to the AMU. There is ongoing variation in acute medical service performance nationally, with significant delays in patient access to appropriate assessment locations.

急症医学服务的绩效受到急症护理服务持续压力的影响。我们利用急症医学学会 2023 年基准审计(SAMBA23)的数据,对照关键临床质量指标评估急症医学服务的绩效,并按初步评估地点对绩效进行比较。对 161 家医院的 8213 次计划外就诊进行了数据分析。按初步评估地点比较,临床质量指标的表现与 2022 年相比没有变化。在急诊科接受评估的日间到达者中,只有 29% 在目标时间内接受了顾问审查。急诊地点之间的转院出现了延误。29%需要入院治疗的患者没有入住急诊室。在全国范围内,急诊医疗服务的表现持续存在差异,患者在前往适当的评估地点时出现严重延误。
{"title":"Evaluating acute medical service performance against assessment time metrics: the Society for Acute Medicine Benchmarking Audit 2023 (SAMBA23).","authors":"Catherine Atkin, Chris Subbe, Mark Holland, Ragit Varia, Tim Cooksley, Adnan Gebril, Adrian Kennedy, Thomas Knight, Daniel Lasserson","doi":"10.52964/AMJA.0984","DOIUrl":"https://doi.org/10.52964/AMJA.0984","url":null,"abstract":"<p><p>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 hospitals. Comparing by initial assessment location, performance against the clinical quality indicators was unchanged from 2022. Only 29% of daytime arrivals assessed within the Emergency Department received consultant review within target times. Delays were seen in transfer between acute care locations. 29% of patients requiring admission were not admitted to the AMU. There is ongoing variation in acute medical service performance nationally, with significant delays in patient access to appropriate assessment locations.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"100-106"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Department Treatment of Elevated Blood Pressure in the Headache Patient. 急诊科对头痛患者血压升高的治疗。
Q3 Medicine Pub Date : 2024-01-01
Lauren Eberhardt, Michelle Jankowski, Brett Todd

Headache accounts for 1 - 3% of emergency department (ED) visits globally and is associated with elevated blood pressure (BP). It is unclear if anti-hypertensive therapy provides benefits. This retrospective study assessed effects of anti-hypertensive therapy in ED headache patients on rescue analgesic need, hospital admissions, and length of stay (LOS). 1385 patients were included. 366 received anti-hypertensive therapy. The anti-hypertensive therapy cohort was older (p < 0.001) with increased odds of admission (p < 0.001) and 2.385 hrs longer ED LOS (p < 0.001). No difference in rescue analgesia was found (p < 0.429). Anti-hypertensive therapy in hypertensive ED headache patients is associated with increased hospital admission and ED LOS, but no difference in rescue analgesia utilization.

头痛占全球急诊科(ED)就诊人数的 1 - 3%,并与血压(BP)升高有关。目前尚不清楚抗高血压治疗是否有益。这项回顾性研究评估了急诊科头痛患者接受降压治疗对抢救镇痛剂需求、入院率和住院时间(LOS)的影响。共纳入 1385 名患者。其中 366 人接受了抗高血压治疗。接受抗高血压治疗的患者年龄较大(p < 0.001),入院几率增加(p < 0.001),急诊室住院时间延长 2.385 小时(p < 0.001)。在镇痛抢救方面没有发现差异(p < 0.429)。高血压急诊室头痛患者的降压治疗与入院率和急诊室生命周期的延长有关,但在使用镇痛抢救方面没有差异。
{"title":"Emergency Department Treatment of Elevated Blood Pressure in the Headache Patient.","authors":"Lauren Eberhardt, Michelle Jankowski, Brett Todd","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Headache accounts for 1 - 3% of emergency department (ED) visits globally and is associated with elevated blood pressure (BP). It is unclear if anti-hypertensive therapy provides benefits. This retrospective study assessed effects of anti-hypertensive therapy in ED headache patients on rescue analgesic need, hospital admissions, and length of stay (LOS). 1385 patients were included. 366 received anti-hypertensive therapy. The anti-hypertensive therapy cohort was older (p < 0.001) with increased odds of admission (p < 0.001) and 2.385 hrs longer ED LOS (p < 0.001). No difference in rescue analgesia was found (p < 0.429). Anti-hypertensive therapy in hypertensive ED headache patients is associated with increased hospital admission and ED LOS, but no difference in rescue analgesia utilization.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 2","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Acute Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1