If there is a (an) unit in the hospital, of say 20 beds, where the medical SHO/Reg sees patients sent over from A/E to arrange their subsequent management then unless the same entity that controls A/E also controls that unit then there will be conflict and the patients will suffer delay and inconvenience or even danger. I think A/E should run both and therefore should "direct" physicians.
>>> Goat <[log in to unmask]> 05/22/02 11:27am >>>
In article <[log in to unmask]>, John PASKINS
<[log in to unmask]> writes
>I for one need to know
>the difference between a CLINICAL DECISION UNIT and a unit where clinical
>decisions are made.
Prediction from Mr Cynical here:
The various confusing acronyms are imposed by the unscrupulous on the
unwary as ways of shunting patients from one queue to another to avoid
embarrassingly bad bed-wait target stats. (Rant over)
I too would be very interested in seeing / developing definitions to
prevent manipulation and misuse of A&E. As usual, the devil will be in
Can I suggest as general starting points the following ideal elements
for any XXU protocol:
A time limit on occupancy.
Regular Senior clinical input.
Efficient use of senior nurse extended roles.
24/7 "backup" services (social services, physio, OT).
Contingency plans for what happens when full.
Entry and exit pathways (especially commitment to provide sufficient in-
patient beds when required)
Clear managerial and clinical lines of responsibility.
As an aside, most of these units are "medical". Does the list feel they
should be a physician's clinical responsibility or A&E?
Dr G Ray
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