Whole-of-hospital response to admission access block: the need for a clinical revolution
| Autor: | David J. Dawson, E. Haydn Walters |
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| Rok vydání: | 2009 |
| Předmět: |
Time Factors
business.industry General physician Accident and emergency Australia General Medicine medicine.disease Health Services Accessibility United Kingdom Unit (housing) Patient flow On board Patient Admission Scale (social sciences) Health Care Reform medicine Humans Medical emergency Medical assessment business Emergency Service Hospital Acute hospital |
| Zdroj: | The Medical journal of Australia. 191(10) |
| ISSN: | 0025-729X |
| Popis: | • The major problem of access block to acute hospital admissions in Australia needs a more radical response than a focus on increasing inpatient beds, as suggested recently. • Australia needs to take on board recent changes in United Kingdom hospital systems, which have revolutionised patient flow during acute admissions and dramatically improved efficiency, clinical quality and outcomes. • Accident and emergency departments in the UK became recognised as part of acute hospital dysfunction. Now, increasingly, patients needing admission are directed as soon as possible to an acute medical assessment and admission unit (AMAAU), thus freeing accident and emergency staff for re-defined core priorities. • AMAAUs require supervision by a new style of acute general physician, who drives timely management of acute medical patients, defines patient needs, estimates the likely date of discharge, and selects the most appropriate inpatient clinical stream. • These reforms are staff-intensive and expensive, but costeffective and patient-focused. They highlight the need for an adequate scale for acute clinical services and defined streams of care within individual hospitals, as well as explicit networking at a regional level to guarantee specialist acute MJA 2009; 191: 561–563 services when needed. |
| Databáze: | OpenAIRE |
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