ACUTE MEDICAL ADMISSIONS - RESULTS OF A NATIONAL AUDIT

The rising number of emergency admissions and the increasing specialis ation of medicine sometimes cause problems in the organisation of care for patients admitted as emergencies to medical beds. A multidiscipli nary working group from general practice and the hospital sector ident ified five main areas in which problems occurred-communication, approp riateness of referral, finding beds, waiting by patients; and the orga nisation of clinical care. Guidelines and standards were suggested. We then carried out an audit of acute care in 42 hospitals with 400 or m ore acute beds. The most significant problems that emerged were the su boptimal involvement of consultants in acute care, the frequent lack o f appropriateness of the admitting specialty to the patient's conditio n, and confusion about policies for admitting elderly patients.