ROLE OF THE SHORT-STAY OBSERVATION WARD IN ACCIDENT AND EMERGENCY DEPARTMENTS IN THE UNITED-KINGDOM

Objective-To define the role of the accident and emergency (A&E) short stay ward by a survey of departments in the United Kingdom and review of published reports. Methods-A postal questionnaire with telephone f ollow up to all major A&E departments with short stay beds. Results-95 departments were found to have short stay beds. These units received between 19 000 and 121 000 new patients per year (mean 51 000, median 50 500) and had access to between two and 20 beds (mean 7.5, median 6) . The level of provision varied from one bed per 2440 new attendances to one bed per 27 250 new attendances (mean 8380, median 6625). Where data on admission rates were available the departments admitted betwee n 0.1% and 13.3% of their new attendances (mean 2.62%, median 1.9%). C over was typically provided by an A&E senior house officer with freque nt senior ward rounds. While the casemix usually included minor head i njuries and alcohol intoxicated patients, there was considerable varia tion in the cases admitted. Conclusions-Short stay provision is highly variable in the United Kingdom. While there are many reports of well run short stay units, consistent evidence of clinical value and cost-e ffectiveness compared to other methods of care is lacking. Further com parative sturdies are required to define the role of the A&E short sta y ward.