Letters to the editor
Characterising the acute medical take
Editor – It is always interesting to read about other hospitals’ medical take and the similarity to your own hospital's workload (Robbins et al, FHJ June 2014 pp. 28–32). However, the authors missed an opportunity to compare their results to others when they suggested little information examined the acute medical take as a whole and instead literature focused on disease entities or appropriateness of scoring systems in isolation. Readers with an interest in acute medicine may like to be directed to the following studies.
The Society of Acute Medicine's work with its national ‘A Day in the Life of the AMU’ Audits started in 2012 and describes the compliance with clinical quality indicators for acute medical units, disease-specific conditions, patient flow and outcomes.1
St James Hospital in Dublin has interrogated their databases and produced reports describing the acute medical take in several ways – regarding generating severity assessment scores with biochemical data (serum sodium, potassium, urea, albumin, red cell distribution and white blood cell) with a median length of stay of 4.5 days and 30 day mortality of 3.9% in 2010; the weekend and weekday case mix and illness severity; and readmission trends and mortality.2–4
Chelsea and Westminster Hospital have described the severity of presentations with their local Chelsea Early Warning Score and the National Early Warning Score (median score on their assessment unit 0 and 1 respectively).5 York Hospital has described the case mix that presents in their acute medical take with 16,000 admission episodes (cardiovascular, respiratory and falls being the top 3 presentations, median age 71 years) and Edinburgh Royal Infirmary has described the medical take in terms of presenting symptoms, referral patterns/source and multi-disciplinary interventions.6,7
- © 2014 Royal College of Physicians
References
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- 4.↵
- Glynn N,
- Bennett K,
- Silke B,
- et al.
- 5.↵
- 6.↵
- 7.↵
- Crosswaite A,
- Dougall H,
- Duguid I,
- et al.
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