Clin Med
-
Accurate prediction of the likelihood of same-day discharge could make it possible to direct one-third of the medical in-take to an ambulatory care unit, thereby facilitating bed management. In Phase 1 of this study, we identified seven independent factors that contribute to an ambulatory care score (Amb score) that can potentially be used as a tool to select ambulatory emergency care (AEC) patients from the medical emergency in-take. ⋯ In Phase 2, we verified and internally validated the performance of the Amb score in a different cohort of patients, finding that it functioned well in identifying early discharges (ie AEC patients), with an area under the receiver operator curve (AUROC) of 0.91 (95% CI 0.88-0.94). An Amb score of > or = 5 has a sensitivity of 96% (95% CI 90-98) and a specificity of 62% (95% CI 55-68) in identifying potential AEC patients.
-
Good public awareness of stroke symptoms and the need for rapid admission to hospital can improve patient outcomes. However, evidence suggests that this awareness is currently inadequate. Therefore, it is important to identify gaps in public knowledge to target public health campaigns appropriately. ⋯ General understanding of stroke was fairly good, although it was found to be worse in the youngest, oldest age and nonwhite groups. Although there was good awareness of the FAST campaign, many people did not know what the individual letters meant. Based on the results of our study, we conclude that it might take considerable time for public awareness campaigns to achieve their full impact.
-
Clinical research contributes to the evidence base for the planning of improved healthcare services and creates an excellent environment for the delivery of healthcare and the recruitment and retention of excellent and well-motivated staff. In this paper, we consider the evidence that a research-intensive healthcare system might yield improved outcomes as a result of the impact of the process of research on the provision of care. We review progress in establishing clinical research networks for cancer and the evidence of the impact of the conduct of clinical cancer research in the National Health Service.