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Research project: Factors influencing the decision to admit to an acute medical bed - Dormant - Dormant

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Rising emergency admissions rates are a recognised problem within the NHS and lead to pressure on acute medical beds. Many suggestions have been proposed as to the causes of this rise, these include decreasing numbers of acute beds, inappropriate acute admissions, increasing numbers of frail elderly patients admitted as emergencies and limited access to acute care alternatives.


Despite the plethora of research into each of these areas, bed crises remain a regular feature within the NHS. However, other areas related to the emergency admission of patients have been largely ignored within the literature. There is evidence to suggest that patients are admitted to acute beds for reasons other than direct clinical need (Phelps 1998). Indeed health professional perception of patient need, irrespective of whether this need is apparent in reality, may have a positive influence on the decision to admit individual patients to acute medical beds.

This study has been designed to investigate, and provide a greater understanding of the factors that are influential in the decision to admit a patient to an acute medical bed. A case study approach will be used. Sixteen patients will be selected to participate; they will broadly represent the population of emergency medical admissions. Patients will be selected over a period of one year from either the accident and emergency department or the emergency medical unit within the local acute trust. The sixteen sampling periods will include weekends and public holidays in order to gain a comprehensive picture of the factors that are influential in the admission process. Data will be collected using interviews with patients and staff about the admission, documentary analysis of patient records and observation of ward activities related to the admission. The data will be analysed for all major themes and related to relevant literature and theory. 

Project team

Judith Lathlean, Bronagh Walsh

Related research groups

Health Work and Systems
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