Acute medicine in the United Kingdom: First‐hand perspectives on a parallel evolution of inpatient medical care
Journal of Hospital MedicinePublished 30 January 2012
G. Randy Smith, Jason M. Stein, Mike C. Jones
Citations4
SJR quartileQ1
SJR score1.08
SNIP1.13
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The development of acute medicine in the UK is traced, current practice is described, and features of the model potentially applicable to hospital Medicine in the US are noted.
Abstract
Additional Supporting Information may be found in the online version of this article. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Keywords
MedicineHealth Professions
New England Journal of MedicineEarly Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock
10,646 Citations2001Emanuel P. Rivers, Bryant Nguyen +6 more
This study randomly assigned patients who arrived at an urban emergency department with severe sepsis or septic shock to receive either six hours of early goal-directed therapy or standard therapy (as a control) before admission to the intensive care unit.
BMJConfidential inquiry into quality of care before admission to intensive care
1,468 Citations1998P. McQuillan, S. Pilkington +7 more
The management of airway, breathing, and circulation, and oxygen therapy and monitoring in severely ill patients before admission to intensive care units may frequently be suboptimal, with major consequences may include increased morbidity and mortality and requirement for intensive care.
JAMANew Requirements for Resident Duty Hours
520 Citations2002Ingrid Philibert
A systematic review of the effectiveness of critical appraisal skills training for clinicians and the impact of an evidence-based medicine curriculum based on adult learning theory on students' reading habits and knowledge is presented.
Journal of General Internal MedicineResults of the Medications At Transitions and Clinical Handoffs (MATCH) Study: An Analysis of Medication Reconciliation Errors and Risk Factors at Hospital Admission
407 Citations2010Kristine M. Gleason, Molly R. McDaniel +5 more
Over one-third of the patients in this study had a medication error at admission, and of these patients, 85% had errors originate in their medication histories, which should focus on older patients with a large number of medications.
Cochrane Database of Systematic ReviewsAntiplatelet therapy for acute ischaemic stroke
262 Citations2008Peter Sandercock, Carl Counsell +2 more
Antiplatelet therapy with aspirin 160 to 300 mg daily, given orally (or per rectum in patients who cannot swallow), and started within 48 hours of onset of presumed ischaemic stroke reduces the risk of early recurrent ischaemia stroke without a major risk ofEarly haemorrhagic complications and improves long-term outcome.
International Journal for Quality in Health CareEffectiveness of acute medical units in hospitals: a systematic review
193 Citations2009Ian Scott, Louella Vaughan +1 more
Limited observational data suggest AMUs reduce in-patient mortality, length of stay and emergency department access block without increasing readmission rates, and improve patient and staff satisfaction.
Archives of Internal MedicinePharmacological Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients
185 Citations2007Lironne Wein
Both UFH and LMWH reduce venous thromboembolic risk in hospitalized medical patients, but neither agent alters mortality, and when directly compared, LMWH is more effective in preventing DVT.
Journal of Hospital MedicineWhere did the day go?—A time‐motion study of hospitalists
130 Citations2010Matthew D. Tipping, Victoria E. Forth +5 more
Multi-tasking occurred frequently and occupied a significant portion of each shift and hospitalists spend more time reviewing the EMR and documenting in it, than directly with the patient.
Annals of Internal MedicineActive Bed Management by Hospitalists and Emergency Department Throughput
125 Citations2008Eric Howell, Edward S. Bessman +4 more
A hospitalist-led bed management program improved emergency department throughput and ambulance-diversion status and was able to facilitate the safe transfer of patients from the emergency department to the appropriate inpatient clinical setting.
Journal of Critical CareHospitalist bed management effecting throughput from the emergency department to the intensive care unit
68 Citations2009Eric Howell, Edward S. Bessman +2 more
Conscientious management of hospital beds, in this case by hospitalist physicians providing ABM, can have a positive and substantial impact on the ED throughput of critically ill patients admitted to ICU beds.
Journal of Hospital MedicineThe impact of fragmentation of hospitalist care on length of stay
65 Citations2010Kenneth Epstein, Esther Juarez +3 more
As FOC increased for pneumonia and heart failure, the LOS increased significantly, and methods to reduce fragmentation should be explored, while more research is needed to identify the source of the relationship between FOC and LOS.
Journal of Hospital MedicineValue‐driven health care: Implications for hospitals and hospitalists
40 Citations2009Patrick H. Conway
Hospitalists can play an essential role in leading and facilitating programs to improve hospital system performance, and should lead change and facilitate solutions to transform the health care system to one that provides high-value care to all.
Clinical MedicineWhat is the effect of a consultant presence in an acute medical unit?
39 Citations2009Gregor McNeill, Darshan H. Brahmbhatt +2 more
The results suggest the absence of a consultant leads to fewer same-day discharges and causes the inappropriate admission of patients not needing inpatient management.
Journal of Hospital MedicineHospitalist time usage and cyclicality: Opportunities to improve efficiency
31 Citations2010Christopher S. Kim, William S. Lovejoy +3 more
A time-motion study of hospitalists carrying the admission pager throughout the 3 types of shifts at the authors' hospital found indirect patient care activities accounted for the majority of admitting hospitalists' time spent in the hospital, with documentation and communication dominating this time.
Journal of Hospital MedicineImplementation of a hospitalist‐run observation unit and impact on length of stay (LOS): A brief report
29 Citations2010Luci K. Leykum, Vincent Huerta +1 more
Implementation of a hospitalist-run observation unit was associated with a significantly decreased LOS for all patients regardless of location, suggesting that the unit has led to more efficient care.