Examples of innovative practice
| Care outside the hospital | Integrating fall prevention practitioners with ambulance services may prevent or accelerate hospital-based assessment8 |
| Telemedicine may optimise the pre-hospital stroke pathway reducing time to assessment by a senior decision maker, enabling appropriate triage to the local ED, hyper-acute stroke unit or thrombectomy centre, reducing delays to treatment and avoiding unnecessary conveyance9 | |
| Integrated electronic records | An integrated care record, the Wirral Care Record, in the North-West of England allows all practitioners can see the health and care information across sectors |
| Well-functioning AMU with SDEC | Sherwood Forest Hospitals NHS Trust acute medical team includes 13 WTE acute medicine consultants, managing an average 50 patient acute take into 83 assessment/short stay ward beds. This, combined with an active SDEC unit, and rapid speciality input when required, enables a very high proportion of patients to be managed without having to be transferred to downstream beds, promoting better patient flow |
| SDEC pathways | The Royal Liverpool Hospital has developed 60 acute medical ambulatory pathways related to specific conditions based on national guidance and written with local specialists provide hospital specialists, providing hospital-specific guidance on rapid assessment and follow up |
| Speciality ‘hot clinics’ | North Bristol's ‘Respiratory hot clinic’ enables 72% of patients attending the service to avoid admission10 |
| Multispeciality acute care | In Sandwell and West Birmingham, a ‘consultant of the week’ model in medical specialities enables timed input to the AMU MDT with subsequent reviews11 |
| Speciality pathways | In Croydon a speciality-nurse-led service enables 70% of acute referrals to be seen on the same day, with a 28% reduction in length of stay12 |
AMU = acute medical unit; ED = emergency department; MDT = multidisciplinary team; SDEC = same-day emergency care; WTE = whole-time equivalent.