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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
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WRAP-process-care-activity-clinically-inclusive-ambulatory-emergency-care-unit-Lasserson-2020.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only until 16 October 2021. Contact author directly, specifying your specific needs. - Requires a PDF viewer. Download (2719Kb) |
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 | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of 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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| Date of first compliant deposit: | 2 December 2020 | ||||||||
| Volume: | 7 | ||||||||
| Number: | 3 | ||||||||
| Page Range: | pp. 234-240 | ||||||||
| DOI: | 10.7861/fhj.2019-0062 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Publisher Statement: | © Clinical Medicine, 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 |
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