Hospital Care in Medical Wards in an East London Teaching Group Hospital

Objective: To assess the rates of inappropriate-ness of admission and last day of care on adult medical wards in an east London hospital, to identify associations with any inappropriateness and to assess what services need to be improved or provided if patients assessed as "inappropriate" are to be more appropriately placed in the future. Design: From the patients ' medical notes, nursing notes and ward charts, a trained reviewer with nursing and university qualifications col-lected concurrent information about each patient's first 24 hours as an in-patient and about the last 24 hours of care preceding discharge. Patients were also interviewed before discharge and 7-10 days after discharge, and their health status and level of satisfaction about the discharge Setting: The three adult medical wards at the Homerton Hospital hi Hackney, east London. This hospital is within the St Bartholomew'