Two retrospective audits were undertaken across several hospitals to understand the frequency and preventability of emergency admissions in people with neuromuscular disease (NMD). Following audit 1 (A1), a number of preventable themes emerged on the basis of which recommendations were made to improve quality and co-ordination of care and a network approach was developed to improve awareness and education amongst patients and non-expert professionals. Audit 2 (A2) was undertaken to determine the effect of these measures. The central NHS IT database identified emergency NMD admissions. Case notes were reviewed and audited against pre-agreed criteria. A1 included 576 admissions (395 patients) A2 included 361 admissions (314 patients). Preventable admissions (where an NMD was known) accounted for 63% in A1 and 33% in A2, with more patients followed up at a specialised neuromuscular centre in A2. There were fewer re-admissions in A2 (12%) compared with A1 (25%) and lower mortality (A1: 4.5%, A2: 0.3%). A2 showed a significant rise in patients admitted under the care of neuroscience during the acute admission and fewer preventable ITU admissions. These audits demonstrate a significant impact for both patient care and potential for financial savings following the implementation of recommendations made after A1.

中文翻译：

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改善对神经肌肉患者的专科护理可减少可预防的急诊住院频率

对多家医院进行了两次回顾性审核，以了解神经肌肉疾病 (NMD) 患者急诊入院的频率和可预防性。在审计 1 (A1) 之后，出现了一些可预防的主题，在这些主题的基础上提出了提高护理质量和协调的建议，并开发了一种网络方法来提高患者和非专家专业人员的意识和教育。进行了审计 2 (A2) 以确定这些措施的效果。NHS 中央 IT 数据库确定了紧急 NMD 入院。案例记录根据预先商定的标准进行了审查和审计。A1 包括 576 次入院（395 名患者） A2 包括 361 次入院（314 名患者）。可预防的入院（已知 NMD）在 A1 中占 63%，在 A2 中占 33%，更多的患者在 A2 的专门神经肌肉中心进行了随访。与 A1 (25%) 相比，A2 (12%) 的再入院率更低，死亡率更低 (A1: 4.5%, A2: 0.3%)。A2 显示在急性入院期间接受神经科学护理的患者显着增加，而可预防的 ITU 入院人数较少。这些审计表明，在实施 A1 之后提出的建议后，对患者护理和财务节约潜力产生了重大影响。