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Delays and interruptions in the acute medical unit clerking process: an observational study

Basey, A. J., Kennedy, T. D., Mackridge, A. J., Krska, Janet (2016) Delays and interruptions in the acute medical unit clerking process: an observational study. JRSM Open, 7 (2). ISSN 2054-2704. (doi:10.1177/2054270415619323) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1177/2054270415619323

Abstract

Objectives It is recommended that patients are seen within 4?h of arrival in Acute Medical Units in English hospitals. This study explored the frequency and nature of interruptions and delays potentially affecting the duration of the Acute Medical Unit admission process and the quality of care provided. Design The admission process was directly observed for patients admitted to the Acute Medical Unit over four one-week periods, November 2009 to April 2011. Setting UK teaching hospital Acute Medical Unit. Participants Hospital staff n?=?36. Main outcome measures Patient waiting times, duration of clerking, number of interruptions and/or delays. Results Thirty-five doctors and one nurse practitioner were observed admitting 71 medical patients, 48/71 (68%) patients were clerked within 4?h of arrival. A delay and/or interruption affected 49/71 (69%) patients. Sixty-six interruptions were observed in 36/71 (51%) of admissions, of these 19/36 (53%) were interrupted more than once. The grade of doctor had no bearing on the frequency of interruption; however, clerking took significantly longer when interrupted; overall doctors grade ST1 and above were quicker at clerking than foundation doctors. Delays affected 31/71 (44%) of admissions, 14/31 (45%) involved X-rays or ECGs; other causes of delays included problems with equipment and computers. Conclusion Interruptions and delays regularly occurred during the admission process in the study hospital which impacts adversely on patient experience and compliance with the recommended 4-h timeframe, further work is required to assess the impact on patient safety. Data obtained from this observational study were used to guide operational changes to improve the process.

Item Type: Article
DOI/Identification number: 10.1177/2054270415619323
Uncontrolled keywords: Acute medical unit; admission; medical history taking; waiting time; interruption; clerking
Subjects: R Medicine > RS Pharmacy and materia medica
Divisions: Faculties > Sciences > Medway School of Pharmacy
Depositing User: Janet Krska
Date Deposited: 06 Oct 2016 10:06 UTC
Last Modified: 29 May 2019 17:57 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/57709 (The current URI for this page, for reference purposes)
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