Emergency Bed Service Research Articles

In-utero transfer is too difficult: Results from a prospective study

BackgoundPerinatal transfer is an unavoidable part of neonatal care. In-utero as opposed to postnatal transfer is recommended whenever possible. AimsTo quantify prevalence of in-utero transfers, determine the duration of time spent arranging in-utero transfers and whether failures in the organisation of potential in-utero transfers were occurring. Study designProspective study of in-utero transfers referred and completed, and questionnaire study of failed potential in-utero transfers. SubjectsWomen referred to the Emergency Bed Service (EBS), women undergoing in-utero transfer by London Ambulance Service (LAS), and preterm infants undergoing postnatal transfer where in-utero transfer had been potentially achievable, in the London area, over a six month period in 2009. Outcome measuresNumber of in-utero transfers being undertaken, duration of time spent arranging in-utero transfer, and number of failed in-utero transfers. ResultsOver the study period LAS undertook 438 in-utero transfers and there were 338 referrals for in-utero transfer to EBS, of which 180 (53%) were successful. Of 69 emergency postnatal transfers of preterm infants (<29weeks gestational age), 11 were classified as failed in-utero transfers. Median (IQR) duration of EBS involvement in in-utero referrals was 340 (200–696)min. A median (IQR) of 240 (150–308)min was spent contacting a median (IQR) of 7 (6–8)units when attempting to arrange in-utero transfer in the failed in-utero transfer group. ConclusionsArranging in-utero transfer consumes considerable clinical time; an important number of in-utero transfer attempts fail for non-clinical reasons; establishment of a centralised in-utero transfer planning service will save clinical time and may improve outcomes.

Effect of a centralised transfer service on characteristics of inter-hospital neonatal transfers

Objective: To determine the effect of a centralised neonatal transfer service on numbers of neonatal transfers and the time taken for teams to reach the baby. Design: Prospective census of...

London GPs face charade to admit patients

Many general practitioners in London have to go through a “time-wasting charade” before getting their patients admitted to hospital, an investigation into London's emergency services by the King's Fund Institute has found. More than one in three general practitioners in London had difficulty getting patients admitted to hospital in an emergency, the report says. Discussions between general practitioners trying to admit patients and hospital doctors could degenerate into confrontation, and when a general practitioner cannot obtain an admission by negotiation “referral to the Emergency Bed Service …

Surveillance of influenza in the United Kingdom

In the United Kingdom the morbidity surveillance is carried out by the General Practitioner Spotter Practice Schemes (RCGP), the Medical Officers of Schools Association (MOSA) and the Emergency Bed Service. Mortality data is provided weekly by the Office of Population and Censuses and Surveys (OPCS). PHLS Communicable Disease Surveillance Centre (CDSC) collects all information and publishes the findings weekly in the Communicable Disease Report (CDR). There are 53 Public Health Laboratories situated in all parts of England and Wales. Most of these laboratories provide diagnostic services for influenza, together with many National Health and academic laboratories. A similar service is also available in Scotland.

Is London overbedded?

To examine whether there are too many hospital beds in London. Analysis of data from the Hospital In-Patient Enquiry, Mental Health Enquiry, health service indicators, and Emergency Bed Service. England, London, and inner London. Hospital admission rates for acute plus geriatric services for London residents were very similar to the national values in all age groups. In the special case considered in the Tomlinson report--acute services in inner London--the admission rate was 22% above the value for England. However, the admission rate of inner deprived Londoners was 9% below that of comparable areas outside London. For psychiatry, admission rates in London roughly equalled those in comparable areas. When special health authorities were excluded, in 1990-1 there were 4% more acute plus geriatric beds available per resident in London than in England. Bed provision has been reduced more rapidly in London than nationally. Extrapolating the trend of bed closures forward indicates that beds (all and acute) per resident in London are now at about the national average. Data from the Emergency Bed Service indicate that the pressure on available hospital beds in London has been increasing since 1985. Data regarding bed provision and utilisation for all specialties by London residents do not provide a case for reducing the total hospital bed stock in London at a rate faster than elsewhere. Bed closures should take account of London's relatively poorer social and primary health care circumstances, longer hospital waiting lists, poorer provision of residential homes, and evidence from the Emergency Bed Service of increasing pressure on beds. Higher average costs in London, some unavoidable, are forcing hospital beds to be closed at a faster rate in London than nationally.

The emergency bed service—the past illuminates the present

The emergency bed service—the past illuminates the present

Letter: Emergency bed service.

Letter: Emergency bed service.

The Pediatric Emergency Bed Service of Brooklyn

A computer-based system for equitable distribution of pediatric inpatients among nine major hospitals in Brooklyn is described. In the first year of operation it has efficiently resolved the problem of overcrowding of city hospitals and underutilization of voluntary hospitals.

Problems of Emergency Admissions to London Hospitals

Difficulty in admitting or failure to admit patients considered to be in urgent need of care and treatment in hospital are frustrating experiences for general practitioners and disquietening and perplexing ones for patients and their relatives. Such episodes are likely to undermine confidence in the organization and administration of the health services. They are, therefore, worthy of detailed study. Previous surveys have shown that delay in hospital admissions is a common complaint among general practitioners (Cartwright, 1964; Cartwright and Marshall, 1965) and that difficulty of admission has been associated particularly with older patients (Gibson, Hughes, and Broughton, 1958) and with maternity cases in London. This last problem has been eased by administrative changes introduced during 1964 (Ministry of Health, 1965) and is not considered in this paper. The study described in this paper followed up all those patients who had been referred with an urgent request for hospital admission to the Emergency Bed Service (EBS) in London during a period of 12 months, but for whom no arrangement could be made for admission at the time of the referral. By comparing this group of patients with groups who were admitted at the time of referral, the influence of age, sex, diagnosis, location, and other factors on the probability of successful emergency admission has been examined. On the basis of the data obtained, suggestions are made about the organization of domiciliary and hospital services.

Intra-Abdominal Crises

Generalizations used in discussing books, diseases, or operations often lose nuances of detail which distinguish one entity from another. Yet a generalization about this volume is applicable to each chapter and each page. This book is thoroughly British, which is to say that it is thoughtfully written in flawless language and is in restrained good taste. Reference material and statistics are minimized, while characterizational phraseology is dominant. Economy of words however does not arise from poverty of ideas. Instead, obviously a large and thoughtful experience is summarized in these pages. References to the British Emergency Bed Service, Ambulance Service, and the status of the doctor under the National Health Service are of interest. True, they do not apply to the abdominal crisis as the American practicioner views it. But they do indicate the rigid partitions which nationalized medicine has raised between the local doctor and the English hospital. It is

Provision of emergency beds in hospitals.

(1) Introduction A number of beds are reserved each day in most hospitals to accommodate emergency cases arriving during the day. Since the number of emergency cases fluctuates considerably from day to day, it is not immediately obvious how many beds should be set aside for this purpose. If all the beds so reserved are filled during the day, any further emergency cases must either be accommodated in extra beds in the centre of a ward, or referred to another hospital. Neither of these expedients can be regarded as fully satisfactory. The former method involves extra duties for hospital staff, and the latter not only causes extra travelling for emergency cases, but also fails to guarantee a bed. In London, for example, where the transfer of applications for beds is very efficiently organized by the King Edward's Hospital Fund Emergency Bed Service, beds are not immediately available for 10 to 15 per cent, of the cases referred to the Service (Daley, 1953). On the other hand, if a large number of emergency beds is provided to satisfy peak demands, many of them will remain empty on days of low demand. As emergency beds can only be reserved at the expense of the beds available for patients on the waiting list, wastage of this kind should be kept as low as possible. The problem thus resolves itself into balancing two opposing factors :

DECEMBER FOG IN LONDON AND THE EMERGENCY BED SERVICE

DECEMBER FOG IN LONDON AND THE EMERGENCY BED SERVICE

Emergency Bed Service

Emergency Bed Service

A YEAR'S APPLICATIONS TO THE LONDON EMERGENCY BED SERVICE

A YEAR'S APPLICATIONS TO THE LONDON EMERGENCY BED SERVICE

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Emergency Bed Service

Voluntary Hospitals Emergency Bed Service

Voluntary Hospitals Emergency Bed Service