Background The direct admission process is a complex system that can be aggravated by inherent gaps in communication leading to inefficient continuity of care and patient safety issues. Bypassing the emergency room, triage is often associated with long periods of unmonitored observation and significant delays in patient assessment. We identified significant communication gaps, delays in placeme...

I’ve never believed that all hospital admissions are undesirable or avoidable. Sometimes admission is the best, only, or safest option. But it shouldn’t avoidably make patients worse for reasons unconnected to the illness causing admission. It’s a bewildering enough start, to be whisked out of your home at short notice into an ambulance, through a busy emergency floor and into the alien environ...

Recent guidance on intermediate care for chronic obstructive pulmonary disease (COPD) highlights the invaluable role of ‘‘early assisted discharge’’ and ‘‘hospital at home’’ in improving patient care and reducing length of hospitalisation for exacerbations [1]. We would like to draw on our novel local experience to suggest a potentially useful addition to such services: namely, a largely patien...

BACKGROUND Management and care of the acutely ill patient has improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient outcome. A likely explanation is the difficulty in retrieving all relevant information from one database. The ...

STUDY OBJECTIVES To compare the case mix and outcomes of male and female patients admitted to intensive care units for a wide range of conditions. DESIGN Cross sectional study of prospectively collected data. SETTING The Intensive Care National Audit and Research Centre, (ICNARC) Case Mix Programme. PARTICIPANTS 46 587 admissions to 91 units across England, Wales, and Northern Ireland. ...

Background: Disseminated bacilli calmette-Guerin (BCG) infection after inoculation with live vaccine is considered to result from impaired immunity of the child. However, half of the cases are regarded as idiopathic because no well-defined immunodeficiency condition can account for the infection. Case report: An 8-month-old male infant was admitted with an ulcer on his left arm at the site ...

OBJECTIVE To determine the prognostic importance of admission time, admission day, admission source, and route of admission, attached devices before admission, diagnosis of patients, and total Simplified Acute Physiology Score (SAPS) II score during admission on intensive care unit mortality rates. METHODS This retrospective study was carried out with 545 patients admitted to adult intensive ...

OBJECTIVES To employ automated bed data to examine whether ICU occupancy influences ICU admission decisions and patient outcomes. DESIGN Retrospective study using an instrumental variable to remove biases from unobserved differences in illness severity for patients admitted to ICU. SETTING Fifteen hospitals in an integrated healthcare delivery system in California. PATIENTS Seventy thousa...