Abstract:
BACKGROUND:For gastroenterology, The Royal College of Physicians reiterates the common practice of two to three consultant ward rounds per week. The Royal Bolton Hospital NHS Foundation Trust operated a 26-bed gastroenterology ward, covered by two consultants at any one time. A traditional system of two ward rounds per consultant per week operated, but as is commonplace, discharges peaked on ward round days. OBJECTIVE:To determine whether daily consultant ward rounds would improve patient care, shorten length of stay and reduce inpatient mortality. METHODS:A new way of working was implemented in December 2009 with a single consultant taking responsibility for all ward inpatients. Freed from all other direct clinical care commitments for their 2 weeks of ward cover, they conducted ward rounds each morning. A multidisciplinary team (MDT) meeting followed immediately. The afternoon was allocated to gastroenterology referrals and reviewing patients on the medical admissions unit. RESULTS:The changes had an immediate and dramatic effect on average length of stay, which was reduced from 11.5 to 8.9 days. The number of patients treated over 12 months increased by 37% from 739 to 1010. Moreover, the number of deaths decreased from 88 to 62, a reduction in percentage mortality from 11.2% to 6%. However, these major quality outcomes involved a reduction in consultant-delivered outpatient and endoscopy activity. CONCLUSION:This new method of working has both advantages and disadvantages. However, it has had a major impact on inpatient care and provides a compelling case for consultant gastroenterology expansion in the UK.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Singh S,Lipscomb G,Padmakumar K,Ramamoorthy R,Ryan S,Bates V,Crompton S,Dermody E,Moriarty Kdoi
10.1136/postgradmedj-2012-100033repsubject
Has Abstractpub_date
2012-10-01 00:00:00pages
583-7issue
1044eissn
0032-5473issn
1469-0756pii
postgradmedj-2012-100033repjournal_volume
88pub_type
杂志文章abstract::Seventy-eight clinically euthyroid patients with atrial dysrhythmias, either established or paroxysmal, and sixty-three patients in sinus rhythm with coronary disease were screened for hyperthyroidism using thyroid function tests including the thyroid-stimulating hormone (TSH) response to thyrotrophin-releasing hormon...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.636.658
更新日期:1978-10-01 00:00:00
abstract:INTRODUCTION:Doctors in all specialties are involved in making "do not attempt resuscitation" (DNAR) decisions; this can be a difficult and challenging process. Guidelines exist to provide an ethical and legal framework for the process and documentation of these decisions. OBJECTIVE:To audit the documentation of resus...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2006.050260
更新日期:2007-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.019182
更新日期:2004-09-01 00:00:00
abstract::A case of vertebral osteomyelitis due to Pseudomonas aeruginosa is described and the problems of diagnosis and treatment discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.620.347
更新日期:1977-06-01 00:00:00
abstract::A 59 year old woman presented with acute onset of fever, chills, diaphoresis, vague chest discomfort, and was found to be hypotensive and tachypnoeic. An electrocardiogram demonstrated sinoatrial block with a junctional rhythm between 50 and 80 beats/min. All cultures were negative and imaging studies unrevealing. Her...
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abstract:PURPOSE:How medical students learn and develop the characteristics associated with good teaching in medicine is not well known. Information about this process can improve the academic preparation of medical students for teaching responsibilities. The purpose of this study was to determine how different experiences cont...
journal_title:Postgraduate medical journal
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doi:10.1136/pgmj.2006.045393
更新日期:2006-09-01 00:00:00
abstract::During the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. Ther...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.734.1125
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between cognitive impairment and conventional measures of disability in multiple sclerosis (MS), quality of life (QOL) and employment status using the brief international cognitive assessment for multiple sclerosis (BICAMS) in the routine outpatient clinic. METHODS:62 patients wi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134071
更新日期:2017-03-01 00:00:00
abstract::A young man developed acute renal failure and hypercalcaemia following severe burns. The hypercalcaemia was initially controlled by haemodialysis, but it persisted after return of renal function. Plasma PTH was inappropriately elevated, but the nephrogenous cyclic adenosine monophosphate level was low; thus the PTH wa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.727.395
更新日期:1986-05-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:1977-05-01 00:00:00
abstract::We report a case of eosinophilic fasciitis, with the unusual features of pulmonary and pleural involvement. Similar cases which involve the lungs have been reported after exposure to L-tryptophan, but there is no relevant drug history in this case. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.891.36
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:Effective communication is a vital part of good clinical care. Traditionally bleep systems have been used as the mainstay of communication. Mobile technology is increasingly seen as a quicker, easier and more reliable method of communication. Our objective was to assess the use of mobile devices within a typ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133722
更新日期:2016-09-01 00:00:00
abstract::A review of the role of presynaptic receptors in the modulation of neurotransmitter release indicates two types of presynaptic receptors. By means of presynaptic inhibitory autoreceptors a neurotransmitter can regulate its own release. In addition, presynaptic receptors are acted upon by other endogenous compounds, ei...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage. The management and follow up is complicated by a lack of guidance on the appropriate use and interpretation of spinal magnetic resonance studies (MR). AIMS:A retrospective study was performed at a UK centre...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2005.032862
更新日期:2006-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.662.862
更新日期:1980-12-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.714.349
更新日期:1985-04-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.714.313
更新日期:1985-04-01 00:00:00
abstract::The risk of developing an overt malignancy after an isolated deep venous thrombosis (DVT) is poorly documented. We therefore reviewed a series of patients in whom a solitary idiopathic DVT had been proven by venography at least 12 months earlier. No patient had developed a malignancy at follow-up. However, decreased f...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.702.275
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:Lactate dehydrogenase (LDH) anomaly is one of the macroenzymes. Macroenzymes are enzymes in serum that have formed high molecular mass complexes, either by self polymerisation or by association with other serum components. The aim of this study was to identify the properties of LDH anomaly and observe the cha...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:2004-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.63.744.907
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更新日期:2015-12-01 00:00:00
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更新日期:1979-05-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.626.749
更新日期:1977-12-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.745.1001
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:The grade cricket competition, also known as premier cricket, supplies players to the state and national teams in Australia. The players involved are generally high-performing amateur (subelite) club cricketers. However, to date, there is no study on the injury epidemiology of Australian grade cricket. AIM:...
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更新日期:2018-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:2006-09-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1984-06-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:1991-08-01 00:00:00