Clin Med
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Quality of care in intensive care and surgery has benefited from establishing comparative standards. At present there is no accepted tool to compare outcomes for emergency admissions in internal medicine. ⋯ Three parameters with poor reproducibility were identified. The SCS has several potential applications: identification of patients with low risk of death suitable for early hospital discharge; early identification of patients with a high risk of death, who will require care in critical care areas (or specialist palliative care); and benchmarking of acute medical departments internationally in a similar way to how APACHE II scoring has been used in critical care units worldwide.
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The European Working Time Directive (EWTD) has resulted in large changes in the working patterns of junior doctors in the U. K. All consultant physicians in England and Wales were invited to anonymously submit data on their teams for 11 am and 11 pm on 5 November 2009. ⋯ Trainees were available for training 66-80% of the time. These findings have significant implications for patient safety and quality of medical training in the U. K.