Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham, B15 2GW, UK. ORCiD ID = 0000-0003-0596-8515.
Departments of Acute Medicine, Manchester University NHS Foundation Trust, UK, M23 9LT and The Christie, Manchester, M20 4BX, UK. ORCID ID: 0000-0001-6114-1956.
Acute Med. 2022;21(1):19-26. doi: 10.52964/AMJA.0888.
The Society for Acute Medicine Benchmarking Audit 2021 (SAMBA21) took place on 17th June 2021, providing the first assessment of performance against the Society for Acute Medicine's Clinical Quality Indicators (CQIs) within acute medical units since the start of the COVID-19 pandemic.
All acute hospitals in the UK were invited to participate. Data were collected on unit structure, and for patients admitted to acute medicine services over a 24-hour period, with follow-up at 7 days.
158 units participated in SAMBA21, from 156 hospitals. 8973 patients were included. The number of admissions per unit had increased compared to SAMBA19 (Sign test p<0.005). An early warning score was recorded within 30 minutes of hospital arrival in 77.4% of patients. 87.4% of unplanned admissions were seen by a tier 1 clinician within 4 hours of arrival. Overall, the medical team performed the initial clinician assessment for 36.4% of unplanned medical admissions. More than a third of medical admissions had their initial assessment in Same Day Emergency Care (SDEC) in 25.4% of hospitals. 62.1% of unplanned admissions were seen by two other clinical decision makers prior to consultant review. Of those unplanned admissions requiring consultant review, 67.8% were seen within the target time. More than a third of unplanned admissions were discharged the same day in 41.8% of units.
Performance against the CQIs for acute medicine was maintained in comparison to previous rounds of SAMBA, despite increased admissions. There remains considerable variation in unit structure and performance within acute medical services.
2021 年急性医学基准审核协会（SAMBA21）于 2021 年 6 月 17 日举行，这是自 COVID-19 大流行开始以来首次对急性医学病房内的急性医学临床质量指标（CQIs）进行评估。
英国所有急性医院均受邀参加。数据收集内容包括单位结构，以及在 24 小时内入院的急性医学服务患者，随访至 7 天。
158 个单位参加了 SAMBA21，来自 156 家医院。共纳入 8973 例患者。与 SAMBA19 相比，单位入院人数有所增加（符号检验 p<0.005）。77.4%的患者在入院后 30 分钟内记录了早期预警评分。87.4%的非计划性入院在入院后 4 小时内由一级临床医生接诊。总体而言，医疗团队对 36.4%的非计划性内科入院进行了初始临床医生评估。在 25.4%的医院中，超过三分之一的内科入院在当天的急诊护理（SDEC）中进行了初始评估。62.1%的非计划性入院在顾问审查前由其他两名临床决策者进行了评估。在需要顾问审查的非计划性入院中，67.8%在目标时间内进行了评估。在 41.8%的单位中，超过三分之一的非计划性入院在当天出院。
与之前的 SAMBA 相比，尽管入院人数增加，但急性医学的 CQIs 绩效仍保持不变。急性医学服务中，单位结构和绩效仍存在相当大的差异。
