Previous toolkits | RCP Medical Care

Acute care toolkit 1: Handover

Handover is the system by which the responsibility for immediate and ongoing care is transferred between healthcare professions. Changing work patterns mean that establishing standards for handover should be a priority.

Acute care toolkit 2: High-quality acute care

Consultant physicians are at the forefront of delivering care to patients presenting to hospital with medical emergencies. Delivering this care depends on competent and expert clinical staff, organised with optimal working arrangements to match patient demand, supported by the right level of resources and facilities.

Acute care toolkit 3: Acute care for older people living with frailty

All staff working in acute medical units (AMUs) will be familiar with the increasing number of older people living with frailty who require access to acute care. The AMU provides a key role in identifying frailty, along with urgent and important issues that need addressing.

Acute care toolkit 4: Delivering a 12-hour, 7-day consultant presence on the acute medical unit

Acute medical illness is a 7-day problem, with patients just as likely to develop an acute illness requiring an emergency admission on a Saturday or Sunday as on a weekday.

Acute care toolkit 5: Teaching on the acute medical unit

Work-based learning and teaching are vital parts of medical education, and AMUs are rich learning environments for a range of health professional and students. High-quality teaching and learning directly impacts on patient safety, quality of care and trainees’ experiences.

Acute care toolkit 6: The medical patient at risk

The toolkit contains advice and examples of effective responses to the National Early Warning Score (NEWS) trigger system, including advice on resource and staff implications. However it is also important to recognise that there are certain clinical situations which define a patient at high risk.

Acute care toolkit 7: Acute oncology on the acute medical unit

This updated toolkit aims to support acute and general medical clinicians caring for patients with cancer who have been admitted to acute care. It outlines key presentations, pathways and complications in acute oncology. It provides service recommendations for acute hospitals and acute oncology services.

Acute care toolkit 8: The medical registrar on call

The medical registrar is perceived by many to be the medical ‘workhorse’ of the hospital and is relied upon heavily by many hospital and community teams. Registrars, however, are concerned about their ability to provide safe, high-quality patient care as their workload increases. This toolkit aims to help hard-pressed and stressed medical registrars improve their workload, training opportunities and supervision.

Acute care toolkit 9: Sepsis

The toolkit provides an overview of sepsis, with useful definitions and stratification tools. AMUs should provide a key role in identifying patients with sepsis, stratifying risk, determining appropriate levels of care, and continuing the resuscitation of patients identified with sepsis prior to AMU admission.

Acute care toolkit 10: Ambulatory emergency care

Ambulatory emergency care is a streamlined way of managing patients presenting to hospital who would traditionally be admitted. This toolkit outlines the principles and highlights some of the benefits of this emerging care pathway.

This toolkit includes:

principles and models of ambulatory emergency care
identification of suitable patients
practical tips for setting up an ambulatory emergency care service.

Acute care toolkit 11: Using data to improve care

The aim of this toolkit is to help physicians to draw together the information that is necessary to understand the quality of care provided by their team, and to work to improve it. This toolkit is also designed to help physicians to draw together the data necessary to understand the local quality of care, measure that care and use the data to improve standards.

The toolkit includes:

a description of the main types of data
considerations of how they should (or should not) be interpreted
how data can be used to help improve healthcare quality.

Acute care toolkit 12: Acute kidney injury and intravenous fluid therapy

Acute kidney injury (AKI) is a common condition that involves sudden, catastrophic loss of kidney function. It is estimated that AKI is associated with one in five emergency hospital admissions and causes up to 1.7 million deaths globally per year. If AKI is not treated promptly, patients have an increased risk of death, owing to changes in their serum biochemistry that affect other organs.

Acute care toolkit 13: Acute care for adolescents and young adults

Adolescents and young adults (AYAs) aged 16–24 account for 36% of emergency department attendances and 20% of those that receive inpatient care.

Compared with older adults, AYAs report:

being less satisfied with their care
being less likely to feel involved in their care
having less confidence and trust in their doctor
being less likely to feel that they are treated with respect and dignity.

Acute care toolkit 15: Managing acute medical problems in pregnancy

This toolkit is essential reading for front-line NHS staff who may be unfamiliar with the normal physiology of pregnancy and/or diseases that present in pregnancy. Challenges arise in managing two lives — the mother and the baby — often leading to a state of clinical inertia.

The toolkit contains:

practical guidance on managing women with acute medical problems in pregnancy
red flags to watch out for in pregnant patients
advice to healthcare staff to ask about a woman’s mental wellbeing when she comes to hospital for other reasons during or after pregnancy
recommendations to improve the standard of acute care for pregnant women.

Acute care toolkit 16: Acute medical care for people with a learning disability

All staff working in acute medical units will care for people with a learning disability who present acutely unwell to hospital. These patients are vulnerable and may be unable to communicate their needs independently.