An assessment tool for acutely ill medical patients

Abstract

This article reports the implementation and impact of a standardized systematic evidence-based predictive score for the initial assessment of acutely ill medical patients. The Simple Clinical Score (SCS) was introduced in the A&E department and the medical floor of the authors' hospital between June 2007 and July 2008. The SCS was well received by the staff - 67% felt it greatly improved patient assessment and was very valuable for ensuring appropriate placement of the patient after admission and improved the quality of care. This article describes the change process, the pilot evaluation and the training programme undertaken during the implementation of the SCS. It is hoped that this experience will be of value to other project teams who are undertaking similar initiatives.

Simple clinical score is associated with mortality and length of stay of acute general medical admissions to an Australian hospital

“…There is no specific training needed for staff to generate this score. 12 Furthermore, in comparison with other scoring systems, such as the Acute Physiologic and Chronic Health Evaluation IV or the Simplified Acute Physiological Score II, time-consuming laboratory investigations are not required with the SCS. 13,14 Although the SCS may be useful to stratify illness severity and subsequent care intensity, it remains to be determined whether its use will ultimately improve patient outcomes.…”

“…Functional capacity and comorbidity are not taken into consideration by most other scores. There is no specific training needed for staff to generate this score 12 . Furthermore, in comparison with other scoring systems, such as the Acute Physiologic and Chronic Health Evaluation IV or the Simplified Acute Physiological Score II, time‐consuming laboratory investigations are not required with the SCS 13,14 .…”

ECG dispersion mapping predicts clinical deterioration, measured by increase in the Simple Clinical Score

“…The nursing staff of the hospital has been fully trained in the use of the SCS since 2007 -implementation of this training process has been reported in a previous publication. 11 The SCS can be quickly performed at the bedside and requires no additional information or investigation other than a 12 lead ECG. 12 Routine laboratory investigations performed at the time of admission were used to calculate the MARS laboratory score on each patient.…”