Ambulatory emergency care (AEC) is an essential component of any acute medical unit (AMU). This statement is predicated on the clinical and financial benefits it confers. In this article, the author outlines the implementation of the Ambulatory Care Unit at Derriford Hospital and the first 6 months of service provision. The initial data collated demonstrates the impact the service has had local...

PURPOSE To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. DESIGN AND METHODS A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic compared with seniors enrolled at the remaining 1...

The perioperative surgical home (PSH) is a system for organizing and coordinating care that is patient-centered, physician-led and teambased. PSH care extends from the decision for surgery until completion of recovery. The main components of the PSH are engaged physician leadership, patient optimization for surgery, timely scheduling, evidence-informed care pathways, expert surgical and anesthe...

OBJECTIVE To explore why patients with cancer treated by London hospitals report worse experiences of care compared with those treated in other English regions. DESIGN Secondary analysis of the 2011/2012 National Cancer Patient Experience Survey (n=69 086). SETTING AND PARTICIPANTS Patients with cancer treated by the English National Health Service (NHS) hospitals. MAIN OUTCOME MEASURES 6...

BACKGROUND Previous studies have shown that it is possible for patient experience to be influenced by factors that are not attributable to health-care. Therefore, if patient experience is to be used as an accurate indicator of clinical performance, then it is important to understand its determinants. METHODS We used data from 840 dialysis patients who completed a validated patient experience ...

stress management for preoperative patients     v. tayebi [1]     abstract     introduction: sugary, regardless of its kind and severity, is a major stress situation for any patient. although, several articles have been published on mentally preparation for surgery, there is still very little knowledge about that.   results: prevention of heavy complications due to preoperative stress, needed t...

To cite: Greaves F, Jha AK. BMJ Qual Saf 2014;23: 525–527. A famous cartoon in the satirical magazine Punch from the 1890s shows a meek curate assuring his dinner host that his egg is not spoiled. “Parts of it are exceptional”, he suggests. We, the knowing reader, appreciate the humour. An egg cannot be good in parts. For those who think about quality, the question of whether care can be good i...

There is considerable interest in ideas borrowed from education about "flipping the classroom" and how they might be applied to "flipping" aspects of health care to reach the Triple Aim of improved health outcomes, improved experience of care, and reduced costs. There are few real-life case studies of "flipping health care" in practice at the individual patient level. This article describes the...