Abstract
BackgroundThere is increased demand for urgent and acute services during the winter months, placing pressure on acute medicine services caring for emergency medical admissions. Hospital services adopt measures aiming to compensate for the effects of this increased pressure. This study aimed to describe the measures adopted by acute medicine services to address service pressures during winter.MethodsA survey of acute hospitals was conducted during the Society for Acute Medicine Benchmarking Audit, a national day-of-care audit, on 30th January 2020. Survey questions were derived from national guidance.Acute medicine services at 93 hospitals in the United Kingdom completed the survey, evaluating service measures implemented to mitigate increased demand, as well as markers of increased pressure on services.ResultsAll acute internal medicine services had undertaken measures to prepare for increased demand, however there was marked variation in the combination of measures adopted. 81.7% of hospitals had expanded the number of medical inpatient beds available. 80.4% had added extra clinical staff. The specialty of the physicians assigned to provide care for extra inpatient beds varied. A quarter of units had reduced beds available for providing Same Day Emergency Care on the day of the survey. Patients had been waiting in corridors within the emergency medicine department in 56.3% of units.ConclusionWinter pressure places considerable demand on acute services, and impacts the delivery of care. Although increased pressure on acute hospital services during winter is widely recognised, there is considerable variation in the approach to planning for these periods of increased demand.
Highlights
Urgent and acute hospital services within the United Kingdom are placed under growing strain year on year, with ongoing increases in the number of patientsAtkin et al BMC Health Services Research (2022) 22:17Medical emergencies are the most frequent cause of unplanned admission to acute hospitals; patients presenting with medical problems are referred from the emergency medicine department or from the community through primary care services for assessment and treatment by the acute internal medicine team [9]
All acute internal medicine services had undertaken measures to prepare for increased demand, there was marked variation in the combination of measures adopted. 81.7% of hospitals had expanded the number of medical inpatient beds available. 80.4% had added extra clinical staff
105 hospitals participated in the audit, with 93 hospitals completing the questions relating to winter pressures (88.6%)
Summary
Medical emergencies are the most frequent cause of unplanned admission to acute hospitals; patients presenting with medical problems are referred from the emergency medicine department or from the community through primary care services for assessment and treatment by the acute internal medicine team [9]. These patients may be acutely unwell, needing rapid diagnosis and initiation of treatment [10]. There is increased demand for urgent and acute services during the winter months, placing pressure on acute medicine services caring for emergency medical admissions.
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