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Process of care and activity in a clinically inclusive ambulatory emergency care unit : progressive effect over time on clinical outcomes and acute medical admissions
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Reschen, Michael E, Bowen, Jordan, Singh, Sudhir, Rajwani, Mridula, Giles, Matthew, Price, James, Lasserson, Daniel and O'Callaghan, Christopher A (2020) Process of care and activity in a clinically inclusive ambulatory emergency care unit : progressive effect over time on clinical outcomes and acute medical admissions. Future Healthcare Journal, 7 (3). pp. 234-240. doi:10.7861/fhj.2019-0062 ISSN 2514-6645.
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Official URL: http://dx.doi.org/10.7861/fhj.2019-0062
Abstract
Clinically relevant outcomes for same-day emergency care provided by ambulatory emergency care units (AECs) are largely unknown. We report the activity and outcomes for a large UK adult AEC operating an ambulatory-care-by-default model without specific exclusion criteria.
The AEC consultant triaged all acute medical referrals to either the AEC or the standard non-ambulatory ‘take’ pathway during AEC opening hours.
The proportion of acute medical referrals seen in the AEC increased to 42% (mean 700 referrals seen per month) in the last 6 months of the study and numbers seen in the non-ambulatory pathway fell. The most common diagnoses were for chest pain, pneumonia, cellulitis, heart failure and urinary system disorders. Seventy-four point eight per cent of patients completed their care in a single visit. In the last calendar year, the conversion rate from AEC to inpatient admission was 12%, and the 30-day readmission rate was 6.9% and 18% for the AEC and non-ambulatory pathways, respectively. Across the whole study period, the 30-day mortality was 1.6% and 6.9% for the AEC and non-ambulatory pathway, respectively.
This ambulatory approach is safe and effective.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Ambulatory medical care , Ambulatory medical care -- Utilization, Hospitals -- Outpatient services | ||||||||
Journal or Publication Title: | Future Healthcare Journal | ||||||||
Publisher: | Royal College of Physicians | ||||||||
ISSN: | 2514-6645 | ||||||||
Official Date: | 2020 | ||||||||
Dates: |
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Volume: | 7 | ||||||||
Number: | 3 | ||||||||
Page Range: | pp. 234-240 | ||||||||
DOI: | 10.7861/fhj.2019-0062 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Re-use Statement: | © Future Healthcare Journal, 2020. The definitive, peer-reviewed and edited version of this article is published in Future Healthcare Journal, 7 (3). pp. 234-240. | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Copyright Holders: | © 2020 Royal College of Physicians | ||||||||
Date of first compliant deposit: | 2 December 2020 | ||||||||
Date of first compliant Open Access: | 16 October 2021 |
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