Show simple item record

dc.contributor.authorBeckett, D. J.
dc.contributor.authorGordon, C. F.
dc.contributor.authorPaterson, R.
dc.contributor.authorChalkley, S.
dc.contributor.authorStewart, C.
dc.contributor.authorJones, Martyn C.
dc.contributor.authorYoung, M.
dc.contributor.authorBell, D.
dc.date.accessioned2018-06-29T21:37:32Z
dc.date.available2018-06-29T21:37:32Z
dc.date.issued2009-05-21
dc.identifierER843
dc.identifier.citationBeckett, 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.issn1460-2725
dc.identifier.urihttp://dx.doi.org/10.1093/qjmed/hcp056
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/843
dc.description.abstractBackground: 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.extent539
dc.publisherOUP
dc.relation.ispartofQJM
dc.titleImprovement in out-of-hours outcomes following the implementation of Hospital at Night
dc.typearticle
dcterms.accessRightsnone
dc.description.facultysch_nur
dc.description.volume102
dc.identifier.doihttp://doi:10.1093/qjmed/hcp056
dc.description.ispublishedpub
dc.description.eprintid843
rioxxterms.typearticle
dc.description.statuspub
dc.description.number8


Files in this item

FilesSizeFormatView

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record