Clin Med
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There is increasing emphasis on prevention of emergency medical readmissions. The broad pattern of acute medical readmissions was studied over a seven-year period and the impact of any readmission on 30-day mortality was recorded. Significant predictors of outcome, including co-morbidity and illness severity score, were entered into a multivariate regression model, adjusting the univariate estimates of the readmission status on mortality. ⋯ This fell to 1.05 (95% CI 1.02 to 1.08) when adjusted for outcome predictors including acute illness severity. The trend for readmissions was to progressively increase over time; the median times between consecutive admissions formed an exponential time series. Efforts to reduce or avoid readmissions may depend on an ability to modify the underlying chronic disease.
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This paper presents an analysis of the views and ideas generated at a recent health policy discussion for doctors in training. This provides an illustration of the creativity and enthusiasm that trainees can bring to the policy sphere by providing unique insights and a fresh perspective.
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This paper describes the implementation of an interprofessional patient record (IPPR) at Sheffield Teaching Hospitals NHS Foundation Trust (STHFT). The IPPR was a two-year project, commencing in May 2008, aimed at creating a single IPPR to which all staff contribute. ⋯ The staff survey and clinical audit data suggest that the IPPR was successfully implemented with many of the perceived benefits realised. The keys to success of this major change project were: time spent engaging clinical staff, board level support, the appointment of a dedicated project team and the involvement and support of many staff involved in patient records throughout STHFT.