Emergency medicine journal : EMJ
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Medical admissions to hospital in the UK are rising by approximately 10% per year. A Medical Assessment Unit (MAU) was opened to help deal with the rising influx of patients. The objectives of this study were to determine if a daily rapid access medical clinic could provide a safe alternative to hospital admission and aid safe discharge for medical patients. ⋯ A daily rapid access medical clinic embedded within a MAU was piloted and allowed the safe management of a variety of medical complaints in an ambulatory fashion. It enabled an increase in the discharge rate of patients referred for admission by general practitioners. This seemed to be more robust than as evidenced previously by a trend towards lower readmission rates. These results were dependent on the presence of a senior clinical decision maker to facilitate safe discharges.
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To measure the reliability and predictive validity of a four-level triage system (I-4L). ⋯ The I-4L triage model shows a good inter-rater and intrarater reliability for rating triage acuity and for accuracy in patient admission and prediction of a reference standard's triage code.
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To investigate the circadian and seasonal patterns in the presentation of acute upper gastrointestinal bleeding (AUGIB) in Beijing, China. ⋯ The presentation of AUGIB in Beijing has a clear seasonal and circadian rhythm. Circadian and seasonal rhythms associated with AUGIB may aid in identifying modifiable risk factors in individuals and populations.
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Balancing pressures of the 4-h wait in Accident and Emergency (A&E) and the National Institute for Clinical Excellence (NICE) requirement for a psychosocial assessment (PSA) before leaving hospital for patients presenting with self-harm is a challenge. This paper suggests a new method for coping with this demand. ⋯ This integrated care pathway (ICP) is evidence of true multidisciplinary working resulting in mutually beneficial outcomes for both the acute and mental health trusts.
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To quantify the determinants of the duration of time spent in an emergency department (ED) for patients who need admission to hospital. ⋯ Increasing hospital capacity is likely to reduce overcrowding in the average ED, but factors that determine congestion in individual hospitals need to be further investigated.