Health trends
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This paper reports the results of a retrospective review which analysed emergency admissions and readmissions of elderly patients to a district general hospital. All patients received standard after-care allocated by the community health and social services departments following referral by hospital staff. ⋯ The findings show that the patients randomly allocated to receive the modest domiciliary after-care service were less likely to have another emergency readmission or multiple readmissions. The results suggest that patients over 75 years-of-age, living alone, or having two or more emergency admissions within six months, should have a domiciliary assessment and follow-up after hospital discharge.
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This paper describes the development of a comprehensive, practical audit by the medical staff at the Accident and Emergency Department at Guy's Hospital. The audit has enabled a comprehensive systematic review of clinical care and its documentation. The results shows that audit of Accident Emergency medicine is possible when channelled by proforma. Junior doctors in this specialty exercise great autonomy, and the audit highlights their need for proper training and guidance from senior medical staff in the review of major and minor cases.
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A questionnaire survey, combined with an observational study, evaluated the knowledge of doctors in training grades on the practical aspects of blood pressure measurement. Eighty (non-consultant) junior hospital doctors, graduates from 30 separate medical schools, participated in the study. ⋯ The precision and accuracy of blood pressure recording is fundamental to the clinical examination of patients, and crucial in their management in both hospital and community settings. The findings of this study support the urgent need for further training and assessment of blood pressure measurement at undergraduate, and postgraduate level.
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This article reviews the background that led to the publication of The New Deal, and sets out the key elements of that agreement. It describes the work aimed at achieving successful implementation, and discusses the principal issues which will influence further progress.