dc.contributor.author | Beckett, D. J. | |
dc.contributor.author | Gordon, C. F. | |
dc.contributor.author | Paterson, R. | |
dc.contributor.author | Chalkley, S. | |
dc.contributor.author | Stewart, C. | |
dc.contributor.author | Jones, Martyn C. | |
dc.contributor.author | Young, M. | |
dc.contributor.author | Bell, D. | |
dc.date.accessioned | 2018-06-29T21:37:32Z | |
dc.date.available | 2018-06-29T21:37:32Z | |
dc.date.issued | 2009-05-21 | |
dc.identifier | ER843 | |
dc.identifier.citation | Beckett, D., Gordon, C., Paterson, R., Chalkley, S., Stewart, C., Jones, M., Young, M. & Bell, D. (2009) Improvement in out-of-hours outcomes following the implementation of Hospital at Night, QJM, vol. 102, , pp. 539, | |
dc.identifier.issn | 1460-2725 | |
dc.identifier.uri | http://dx.doi.org/10.1093/qjmed/hcp056 | |
dc.identifier.uri | https://eresearch.qmu.ac.uk/handle/20.500.12289/843 | |
dc.description.abstract | Background: Hospital at Night (H@N) is a Department of Health (England) driven programme being widely implemented across UK. It aims to redefine how medical cover is provided in hospitals during the out-of-hours period.
Aim: To investigate whether the implementation of H@N is associated with significant change in system or clinical outcomes.
Design: An observational study for 14 consecutive nights before, and 14 consecutive nights after the implementation of H@N. Data were collected from the Combined surgical and medical Assessment Unit (CAU), the 18 medical/surgical wards (The Ward Arc) and the four High Dependency Units (The Critical Care corridor) within the Royal Infirmary of Edinburgh.
Methods: Following an overnight episode of clinical concern, data were gathered on response time, seniority of reviewing staff, patient outcome and the use of Standardized Early Warning Score (SEWS).
Results: Two hundred and nine episodes of clinical concern were recorded before the implementation of H@N and 216 episodes afterwards. There was no significant change in response time in the CAU, Ward Arc or Critical Care corridor. However, significant inter-speciality differences in response time were eradicated, particularly in the Critical Care corridor. Following the implementation of H@N, patients were reviewed more frequently by senior medical staff in CAU (28% vs. 4%, P < 0.05) and the Critical Care corridor (50% vs. 22%, P < 0.001). Finally there was a reduction in adverse outcome (defined as unplanned transfer to critical care/cardiac arrest) in the Ward Arc and CAU from 17% to 6% of patients reviewed overnight (P < 0.01). SEWS was more frequently and accurately recorded in CAU.
Conclusion: This is the first study that we are aware of directly comparing out-of-hours performance before and after the implementation of H@N. Significant improvements in both patient and system outcomes were observed, with no adverse effects noted. | |
dc.format.extent | 539 | |
dc.publisher | OUP | |
dc.relation.ispartof | QJM | |
dc.title | Improvement in out-of-hours outcomes following the implementation of Hospital at Night | |
dc.type | article | |
dcterms.accessRights | none | |
dc.description.faculty | sch_nur | |
dc.description.volume | 102 | |
dc.identifier.doi | http://doi:10.1093/qjmed/hcp056 | |
dc.description.ispublished | pub | |
dc.description.eprintid | 843 | |
rioxxterms.type | article | |
dc.description.status | pub | |
dc.description.number | 8 | |