Acute Care: Challenges, Solutions, Quality, Access

Miguel Torres^*
*Correspondence: Miguel Torres, Department of Palliative Care Nursing, Universidad del Sol, Madrid, Spain, Email:

Introduction

Acute care environments face numerous challenges, from operational bottlenecks to the imperative of high-quality, equitable patient care. Emergency department crowding is a major obstacle, jeopardizing patient outcomes, increasing mortality, and prolonging hospital stays. Effective strategies are crucial to mitigate these effects [1].

Specialized care models are also key. Geriatric Emergency Department (GED) accreditation improves outcomes for older adults, reducing hospital admissions and enhancing patient satisfaction through tailored approaches [2].

Advanced technologies like telemedicine are transforming acute care, particularly in emergency medical services, by enabling remote consultations and improving access to specialized care, vital for rural or underserved populations [3].

Quality of care profoundly relies on staffing. Adequate nurse staffing levels in acute care hospitals directly link to improved patient outcomes, including lower mortality rates and reduced readmissions, highlighting nursingâ??s critical role in quality care delivery [4].

Despite efforts, patient safety incidents persist in acute care. Common factors include communication breakdowns, inadequate staffing, and medication errors, necessitating comprehensive safety protocols [5].

Swift and decisive medical responses are often life-saving. Early identification and aggressive management of sepsis are critical in acute care, with adherence to guidelines and emerging therapeutic strategies significantly improving patient survival and reducing complications [6].

Integrating mental health services within acute medical care settings is essential for holistic management, addressing the complex interplay between physical and psychological health for improved overall outcomes [7].

Ensuring continuity of care post-discharge is equally important. Effective transitions from acute care to post-acute settings are crucial for continuity, preventing readmissions, and optimizing patient recovery, necessitating well-coordinated multidisciplinary approaches [8].

Addressing health disparities in acute care, particularly within emergency medicine, is vital for health equity, requiring targeted interventions to ensure equitable access and quality of care for all [9].

Finally, combating emerging health threats is constant. Antimicrobial stewardship programs are fundamental in acute care to combat antibiotic resistance, optimizing antibiotic use through surveillance and intervention strategies. This improves patient outcomes and reduces healthcare costs [10].

Collectively, these areas represent critical focal points for enhancing acute care delivery.

Description

Acute care environments, encompassing emergency departments and hospitals, grapple with multifaceted operational challenges. Emergency department crowding, for instance, is not merely an inconvenience; it represents a profound systemic issue that directly compromises patient outcomes, elevating mortality rates, and prolonging hospital stays. Strategic and effective interventions are critically needed to alleviate these adverse effects [1]. Moreover, patient safety remains a significant concern. Incidents often stem from communication breakdowns, inadequate staffing, and medication errors. This necessitates the implementation of robust, comprehensive safety protocols to protect vulnerable patients in these high-stakes settings [5]. These interwoven issues highlight the continuous need for vigilance and improvement in foundational operational processes.

The demographic shifts and specific patient needs also shape acute care delivery. Providing specialized care for older adults has become increasingly important, exemplified by Geriatric Emergency Department (GED) accreditation. This initiative has shown positive impacts, leading to reduced hospital admissions and improved patient satisfaction by tailoring care models to the unique requirements of the elderly [2]. Beyond age-specific considerations, the foundational element of adequate nurse staffing levels in acute care hospitals cannot be overstated. Research consistently links appropriate staffing to improved patient outcomes, including demonstrably lower mortality rates and reduced readmissions, thereby affirming the indispensable role of nursing in ensuring quality care delivery [4].

Technological innovation and comprehensive care are driving significant transformations. Telemedicine, in particular, has emerged as a powerful tool in acute care and emergency medical services. It enables crucial remote consultations, dramatically enhancing access to specialized medical expertise, especially for geographically isolated or underserved populations who might otherwise face significant barriers to care [3]. Concurrently, a holistic approach to patient well-being demands integrating mental health services directly within acute medical care settings. This integration is vital for addressing the complex interplay between physical and psychological health, ultimately paving the way for improved overall patient outcomes and a more comprehensive care experience [7].

Critical medical conditions necessitate immediate and expert management. Sepsis, for example, demands prompt identification and aggressive therapeutic intervention in acute care settings. Adherence to established clinical guidelines, coupled with the adoption of emerging treatment strategies, has been shown to significantly enhance patient survival rates and minimize the long-term complications associated with this life-threatening condition [6]. In parallel, the broader fight against infectious diseases, specifically antimicrobial resistance, relies heavily on diligent practice. Antimicrobial stewardship programs are therefore fundamental in acute care hospitals. These programs aim to optimize antibiotic use through continuous surveillance and targeted interventions, which not only improves individual patient outcomes but also plays a crucial role in curbing the spread of resistance and reducing overall healthcare costs [10].

Finally, ensuring equitable access and continuity across the healthcare spectrum are paramount for effective acute care. Addressing pervasive health disparities, particularly within emergency medicine, is not just a matter of policy but a moral imperative for achieving true health equity. Targeted interventions are essential to guarantee equitable access and consistent quality of care for all populations, regardless of their background or socioeconomic status [9]. Furthermore, the transition of patients from acute hospitals to post-acute care settings represents a critical juncture. Effective, well-coordinated transitions are crucial for maintaining continuity of care, actively preventing avoidable readmissions, and optimizing patient recovery. This demands multidisciplinary approaches that bridge institutional gaps and support patients throughout their recovery journey [8]. These systemic improvements are vital for a truly patient-centered and efficient acute care system.

Conclusion

Acute care faces pressing challenges including emergency department crowding, which negatively impacts patient outcomes, and persistent patient safety incidents, often due to communication issues, staffing shortages, and medication errors. To counteract these, strategic interventions are crucial. Enhancing care for specific populations is evident through Geriatric Emergency Department accreditation, improving outcomes for older adults, and the critical importance of adequate nurse staffing, directly linked to lower mortality and readmissions. Technological advancements like telemedicine are also transforming emergency medical services by enabling remote consultations, expanding access, especially for underserved areas. Management of critical conditions like sepsis relies on prompt identification and adherence to guidelines for better survival rates. Furthermore, integrating mental health services into acute medical care is key for holistic patient management. Systemic improvements include focusing on effective care transitions from acute to post-acute settings to prevent readmissions and addressing health disparities in emergency medicine to achieve health equity. Lastly, antimicrobial stewardship programs are vital in combating antibiotic resistance by optimizing antibiotic use, improving patient outcomes, and reducing healthcare costs. These diverse efforts collectively aim to enhance the quality, safety, and accessibility of acute care.

Acknowledgement

None

Conflict of Interest

None

References

1. Afsana A, Sadiat S, Nazmul H. "Emergency Department Crowding and Its Association with Patient Outcomes: A Systematic Review".J Emerg Med 64 (2023):577-590.

Indexed at, Google Scholar, Crossref

2. Laura RG, Lauren CW, Katherine MB. "Geriatric Emergency Department Accreditation and Older Adult Outcomes: A Systematic Review".Acad Emerg Med 28 (2021):3-12.

Indexed at, Google Scholar, Crossref

3. Robert FG, Stephen JK, Daniel ME. "The Role of Telemedicine in Emergency Medical Services and Acute Care: A Scoping Review".West J Emerg Med 21 (2020):7-19.

Indexed at, Google Scholar, Crossref

4. Linda HA, Douglas MS, Jianfang L. "Impact of Nurse Staffing on Patient Outcomes in Acute Care Hospitals: A Systematic Review and Meta-analysis".Med Care 61 (2023):698-705.

Indexed at, Google Scholar, Crossref

5. Mohammad A, Sara RM, Mustafa A. "Patient Safety Incidents in Acute Care: A Systematic Review of Incidence and Contributing Factors".J Patient Saf 17 (2021):e1450-e1458.

Indexed at, Google Scholar, Crossref

6. Sean RB, Jessica MH, David RW. "Early Recognition and Management of Sepsis in Acute Care: A Review of Current Guidelines and Emerging Strategies".Crit Care Med 48 (2020):e428-e438.

Indexed at, Google Scholar, Crossref

7. Jennifer EPS, Michael TW, Sarah LE. "Integration of Mental Health Services in Acute Medical Care: A Scoping Review".Gen Hosp Psychiatry 77 (2022):25-34.

Indexed at, Google Scholar, Crossref

8. Mary AB, David JC, Emily FP. "Care Transitions from Acute Hospital to Post-Acute Care Settings: A Systematic Review of Effectiveness and Interventions".J Am Geriatr Soc 67 (2019):1886-1895.

Indexed at, Google Scholar, Crossref

9. Elizabeth DK, Marc RM, Lisa CB. "Health Equity in Emergency Medicine: A Systematic Review of Disparities in Acute Care".Ann Emerg Med 80 (2022):461-470.

Indexed at, Google Scholar, Crossref

10. Michael JR, Kalpana G, Jason MP. "Antimicrobial Stewardship Programs in Acute Care Hospitals: A Systematic Review of Interventions and Outcomes".Clin Infect Dis 73 (2021):e2901-e2912.

Indexed at, Google Scholar, Crossref