A5102812255- Emergency and Acute Care Studies
- Respiratory Support and Mechanisms
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Healthcare Policy and Management
- Cardiac Arrest and Resuscitation
- Geriatric Care and Nursing Homes
- Healthcare Systems and Challenges
- Hospital Admissions and Outcomes
- Healthcare Operations and Scheduling Optimization
- Neuroscience of respiration and sleep
- Poisoning and overdose treatments
- COVID-19 Clinical Research Studies
- Central Venous Catheters and Hemodialysis
- Patient Safety and Medication Errors
- Occupational Health and Safety Research
- Climate Change and Health Impacts
- Healthcare cost, quality, practices
- Medical Education and Admissions
- Obstructive Sleep Apnea Research
- Cardiac Imaging and Diagnostics
- Employment and Welfare Studies
- Radiology practices and education
- Health disparities and outcomes
- Competency Development and Evaluation
- Coronary Interventions and Diagnostics
Royal College of Emergency Medicine
2019-2023
Virginia Commonwealth University
2021
Guy's and St Thomas' NHS Foundation Trust
2011-2020
St Thomas' Hospital
2010-2017
Kings Health Partners
2015
Homerton University Hospital
2004
<h3>Rationale</h3> Hospitalised patients with acute exacerbation of COPD may deteriorate despite treatment, early readmission being common. <h3>Objectives</h3> To investigate whether neural respiratory drive, measured using second intercostal space parasternal muscle electromyography (EMG<sub>para</sub>), would identify worsening dyspnoea and physician-defined inpatient clinical deterioration, predict readmission. <h3>Methods</h3> Patients admitted to a single-site university hospital were...
Escalation policies are used by emergency departments (EDs) when responding to an increase in demand (eg, a sudden inflow of patients) or reduction capacity lack beds admit patients). The aim maintain the ability deliver patient care, without compromising safety, modifying "normal" processes. study objective is examine escalation theory and practice.This was mixed-method involving conceptual analysis National Health Service (n=12) associated actions (n=92), as well detailed ethnographic situ...
<b><i>Objective:</i></b> To perform a health maintenance organization–based case-control study to evaluate the association of total and high density lipoprotein (HDL) cholesterol with risk stroke subtypes in patient subgroups. <b><i>Methods:</i></b> Cases had confirmed incident ischemic (n = 1,242) or hemorrhagic 313). Controls 6,455) were identified companion myocardial infarction study. Risk was modeled using logistic regression. <b><i>Results:</i></b> The highest quintile associated an...
This study aimed to examine the importance of fatigue as a clinical indicator in chronic obstructive pulmonary disease (COPD), by analysing its relationship with COPD severity and ability predict risk hospitalisation, comparing intensity stable patients levels reported other conditions. We studied 100 consecutive attending assessment clinics before rehabilitation. Both questionnaire physiological data were collected. Partial correlations, multiple linear regressions Cox proportional hazard...
Central venous catheter placement is a common procedure with high incidence of error. Other fields requiring reliability have used Failure Mode and Effects Analysis (FMEA) to prioritize quality safety improvement efforts.To use FMEA in the development formal, standardized curriculum for central training.We surveyed interns regarding their prior experience placement. A multidisciplinary team identify high-priority failure modes develop online hands-on training modules decrease frequency,...
Since March 2020, UK researchers have established over 70 urgent public health studies to investigate potential treatments, vaccines, and diagnostic tests for covid-19.NHS hospitals had a vital role in delivering these at pace scale, despite working under extreme pressure.The results are now informing practice worldwide.
<h3>Aim</h3> To investigate the impact, in terms of hospital admission and investigations, individual care plans for patients who frequently attend emergency department (ED). <h3>Method</h3> 32 regularly attended ED at St Thomas9 Hospital were included study. After review case records, an plan was prepared future attendances. The numbers attendances, admissions investigations collated from electronic patient record system compared 12 months prior to after introduction plan. Primary outcome...
Exit block and crowding create conditions in emergency departments that can harm patients the staff who look after them. Key to solving exit is recognizing it exists whole hospital involved preventing harmful consequences.
Aims: In 2015, the European Society of Cardiology introduced new guidelines for diagnosis acute coronary syndromes in patients presenting without persistent ST-segment elevation. These included use high-sensitivity troponin assays ‘rule-in’ and ‘rule-out’ myocardial injury at presentation (using a ‘0 hour’ blood test). Whilst these algorithms have been extensively validated prospective diagnostic studies, outcome their implementation routine clinical practice has not described. The present...
"Aligning faculty development with competencies for professional growth." Medical Teacher, 43(8), pp. 900–901
Outcome data is often hard to find in Emergency Medicine (EM) and outcome about the process of acute care even rarer. As a Royal College we write clinical standards advise on workforce strategy, but it link those recommendations what actually happens patients. Han et al collaboration between two business schools, biostatistics departments large emergency department (ED) have managed add patient relating ED debate known as ‘weekend effect’.1 The need for such heavyweight statistical input...
Recognising how big a problem we currently have in the NHS is beginning of trying to solve it We all depend on having functional emergency system available when need most, writes Katherine Henderson
<h3>Background</h3> During AECOPD, expiratory flow limitation results in dynamic hyperinflation (DH), respiratory neuromechanical uncoupling, and increased work of breathing causing breathlessness. We have previously demonstrated that 2nd intercostal space EMG<sub>para</sub>, as a direct marker neural drive (NRD), is able to detect clinical change hospitalised AECOPD patients. hypothesised EMG<sub>para</sub> has an indirect relationship with DH. <h3>Method</h3> Patients admitted at...