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[null,"Baseline assessment tool for emergency and acute medical care in over 16s: service delivery and organisation (NICE clinical guideline NG94)"]
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[null,"This baseline assessment tool can be used to evaluate whether practice is in line with the recommendations in Emergency and acute medical care in over 16s: service delivery and organisation.  It can also help to plan activity to meet the recommendations."]
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[null,"The tool can be used by individual services or organisations. Alternatively, an assessment completed with the involvement of all relevant services or organisations would help to develop a picture of activity in the local area."]
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[null,"It should be used in conjunction with Emergency and acute medical care in over 16s: service delivery and organisation (NICE clinical guideline NG94)."]
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[null,"In the first instance, consider whether the guideline is relevant and record the conclusion in the box below."]
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[null,"Is the guideline relevant?"]
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[null,"The data sheet contains the recommendations from the guideline. Information can be entered about current activity relevant to the recommendation, actions needed to meet the recommendation, deadlines and the names of the responsible leads.  Useful documents can be added as hyperlinks."]
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[null,"The table can be adapted to include any other local information that is thought to be useful."]
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[null,"If it would be helpful to group the recommendations, for example those that are key priorities for implementation or by deadline, use the filter function in the data menu. "]
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[null,"Tools and resources to help put the guidance into practice are available on the NICE website. "]
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[null,"National Institute for Health and Care Excellence\nLevel 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT; www.nice.org.uk\n\nCopyright\n© NICE 2018. All rights reserved. Subject to Notice of rights.\n"]

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[null,"Baseline assessment tool for emergency and acute medical care in over 16s: service delivery and organisation (NICE clinical guideline NG94)"]
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[null,null,null,null,"Number of relevant recommendations",{"$f":"COUNTIF(D8:D40,\"Yes\")","v":0}]
[null,null,null,null,"Number of recommendations met",{"$f":"COUNTIF(F8:F40,\"Yes\")","v":0}]
[null,null,null,null,"Percentage of recommendations met",{"$f":"IF(ISERROR(F4/F3),\"\",F4/F3)","v":""}]
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[null,"NICE recommendation","Guideline reference","Is the recommendation relevant?","Current activity/evidence","Recommendation met?","Actions needed to implement recommendation","Is there a risk associated with not implementing this recommendation?","Is there a cost or saving?","Deadline","Lead"]
[null,"1.1  Emergency and acute medical care in the community"]
[null,"First points of contact with healthcare services"]
[null,"Provide specialist and advanced paramedic practitioners who have extended training in assessing and treating people with medical emergencies. [See the evidence review  on paramedics with enhanced competencies.]","1.1.1"]
[null,"Provide point-of-care C-reactive protein testing for people with suspected lower respiratory tract infections. [See the evidence review on GP access to laboratory investigations.]","1.1.2"]
[null,"For people who are at increased risk of developing a medical emergency:\n• provide advanced community pharmacy-based services\n• consider providing advanced pharmacist services in general practices. [See the evidence review on community-based pharmacists.]","1.1.3"]
[null,"For people at risk of an acute medical emergency, do not commission pharmacists to conduct medication reviews in the home unless needed for logistical or clinical reasons. [See the evidence review on community-based pharmacists.]","1.1.4"]
[null,"Alternatives to hospital care"]
[null,"Provide nurse-led support in the community for people at increased risk of hospital admission or readmission. The nursing team should work with the team providing specialist care. [See the evidence review on community nursing.]","1.1.5"]
[null,"Provide multidisciplinary intermediate care as an alternative to hospital care to prevent admission and promote earlier discharge. Ensure that the benefits and risks of the various types of intermediate care are discussed with the person and their family or carer. [See the evidence review on alternatives to hospital care.]","1.1.6"]
[null,"Provide a multidisciplinary community-based rehabilitation service for people who have had a medical emergency. [See the evidence review on community rehabilitation.]","1.1.7"]
[null,"Provide specialist multidisciplinary community-based palliative care as an option for people in the terminal phase of an illness. [See the evidence review on community palliative care.]","1.1.8"]
[null,"Offer advance care planning to people in the community and in hospital who are approaching the end of life and are at risk of a medical emergency. Ensure that there is close collaboration between the person, their families and carers, and the professionals involved in their care. [See the evidence review on advance care planning.]","1.1.9"]
[null,"1.2  Emergency and acute medical care in hospital"]
[null,"Managing hospital admissions"]
[null,"Use validated risk stratification tools to inform clinical decisions about hospital admission for people with medical emergencies. [See the evidence review on standardised criteria for hospital admission.]","1.2.1"]
[null,"Assess and treat people who are admitted with undifferentiated medical emergencies in an acute medical unit. [See the evidence review on assessment through acute medical units.]","1.2.2"]
[null,"Provide access to liaison psychiatry services for people with medical emergencies who have mental health problems. [See the evidence review on liaison psychiatry.]","1.2.3"]
[null,"Start discharge planning at the time of admission for a medical emergency. [See the evidence review on discharge planning.]","1.2.4"]
[null,"Timing and frequency of consultant reviews"]
[null,"For people admitted to hospital with a medical emergency, consider providing the following:\n• consultant assessment within 14 hours of admission to determine the person’s care pathway\n• daily consultant review, including weekends and bank holidays\n• more frequent (for example, twice daily) consultant review based on clinical need.\n\n[See the evidence reviews on early versus late consultant review and frequency of consultant review.]","1.2.5"]
[null,"Providing services within the hospital"]
[null,"Provide coordinated multidisciplinary care for people admitted to hospital with a medical emergency. [See the evidence review on multidisciplinary team meetings.]","1.2.6"]
[null,"Include ward-based pharmacists in the multidisciplinary care of people admitted to hospital with a medical emergency. [See the evidence review on pharmacist support.] ","1.2.7"]
[null,"Provide access to physiotherapy and occupational therapy 7 days a week for people admitted to hospital with a medical emergency. [See the evidence review on enhanced inpatient access to physiotherapy and occupational therapy.]","1.2.8"]
[null,"Consider providing access to critical care outreach teams (CCOTs) for people in hospital who have, or are at risk of, acute deterioration, accompanied by local evaluation of the CCOT service. [See the evidence review on critical care outreach teams.]","1.2.9"]
[null,"Organising ward rounds, handovers and transfers"]
[null,"Use standardised and structured approaches to ward rounds, for example with checklists or other clinical decision support tools. [See the evidence review on structured ward rounds.]","1.2.10"]
[null,"Use structured handovers during transitions of care and follow the recommendations on transferring patients in the NICE guideline on acutely ill patients in hospital. [See the evidence review on structured patient handovers.]","1.2.11"]
[null,"Use standardised systems of care (including checklists, staffing and equipment) when transferring critically ill patients within or between hospitals. [See the evidence review on standardised systems of care for intra- and inter-hospital transfers.]","1.2.12"]
[null,"1.3  Planning emergency and acute care services"]
[null,"Recommendations for commissioners and providers of health and social care"]
[null,"Healthcare providers should:\n• monitor total acute hospital bed occupancy, capacity, flow and outcomes in real time, taking account of changes in a 24-hour period and the occupancy levels and needs of specific wards and units\n• plan capacity to minimise the risks associated with occupancy rates exceeding 90%. [See the evidence review on bed occupancy.]","1.3.1"]
[null,"Health and social care systems should develop and evaluate integrated care pathways. [See the evidence review on integrated care.]","1.3.2"]