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Index

Published online by Cambridge University Press:  01 July 2020

Edited by
Martin McKee ,
Sherry Merkur ,
Nigel Edwards  and
Ellen Nolte
Assisted by
Jonathan North
Martin McKee
Affiliation:
London School of Hygiene and Tropical Medicine
Sherry Merkur
Affiliation:
European Observatory on Health Systems and Policies
Nigel Edwards
Affiliation:
The Nuffield Trust
Ellen Nolte
Affiliation:
London School of Hygiene and Tropical Medicine
Jonathan North
Affiliation:
European Observatory on Health Systems and Policies

Summary

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Chapter
Information
The Changing Role of the Hospital in European Health Systems , pp. 298 - 306
Publisher: Cambridge University Press
Print publication year: 2020
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This content is Open Access and distributed under the terms of the Creative Commons Attribution licence CC-BY-NC-ND 3.0 https://creativecommons.org/cclicenses/

Index

Page numbers in italics denote figures.

Accident and Emergency (A&E), 181 see also emergency medicine
accountability, 7
acidosis, respiratory, 158, 168
admissions to hospital 155–7, 189–190
Advanced Nurse Practitioners, 107
adverse drug reactions, 104–105
agesee older patients
ageism, 106, 206
air quality, in neonatal intensive care, 31
alcohol, 193
allergies, 44
alteplase, 57, 72
ambulance services, 45, 185
ambulatory care, 90–91, 149, 153, 172, 295 see also outpatient clinics
surgery, 218
anaesthesia, 224
anaesthetists, 210, 218–220
antibiotics, 43–44, 277, 282
anticoagulants, 74–75
antimicrobial resistance, 5, 16, 43–44, 274, 277, 288
antiplatelet agents, 74–75
aortic aneurysm, 237
assisted ventilation, 32
assistive technologies, 77
asthma, 44
atrial fibrillation, 74–75
automation, in laboratories, 261
autopsies, 279–280, 281
babies, premature, 11, 27, 29–33
Baby-friendly Hospital Initiative (BFHI), 30
Barcelona, Spain, telehealth team, 163
bed capacity, lack of, 189
bed rest, 89
biological therapy, 124, 132
biosensor point of care devices, 282–283
birth rate, falling, 23–24
brain imaging, 60–61, 71, 75
brain repair, 77
Bromiley, Martin, 224
bronchiolitis, 43–44
bronchoscopic lung volume reduction (BLVR), 154
cancer, 13–14, 120–139, 238, 240, 247
burden of cancer in Europe, 121–123
cancer care, 123–127
multidisciplinary teams, 127–129
barriers to delivering optimal care, 130–132
immunotherapy, 124, 132–133
image guided interventions, 132, 133–134, 252
survivorship, 134–135
organizational trends, 135–139
Irish National Cancer Control Programme, 266–267
cardiology, 244–245
Cardiopulmonary Exercise testing (CPET), 211
care
in the community, 127
home-based, 102–103, 104, 105, 227
intermediate, 91–92, 105
care bundles, 215–217
care qualitysee quality of care
Charter of the European Association for Children in Hospital (EACH), 38–39
chemotherapy, 123, 127, 132
child health care, 11–12, 22–49
child health care in Europe, 22–27
child-friendly, 24–26, 48
neonatal care, 27–34
secondary care / hospitalization, 34–39
tertiary care / specialized paediatric centres, 39–43
patient pathways, 43–46
challenges, 48–49
chronic disease, 14, 24, 44, 45–46, 145, 193, 293 see also COPD
cancer, 134–135
SIKS project, Copenhagen, Denmark, 165
chronic obstructive pulmonary diseasesee COPD
clinical genomics, 260
Clinical Human Factors Group (CHFG), 224
clinical scientists, roles in cellular pathology, 272–273
clinics
ambulatory care, 90–91
pre-assessment, 211–212
virtual, 156
coaching, 226
collaboration, 291–292
geriatric-surgical, 95–99
laboratory medicine, 259–260
communication, 208, 277
communications technology, 156, 228, 289, 294 see also information technology
community, 127, 155–156
community hospitals, 91–92
Comprehensive Geriatric Assessment (CGA), 92–93, 95, 209–210
computerized tomography (CT), 12, 71, 75, 235, 246, 248–251
connectivity, 296–297
COPD (chronic obstructive pulmonary disease), 14, 145–172
definition, 146–147
burden of, 147–149
care, 149–154
exacerbations, 154–166
hospital care, 157–159, 160, 161
post hospital care and rehabilitation, 159, 162–166
workforce, 166–168
specialist resources, 168–170
barriers to delivering optimal care, and the future, 170–172
Copenhagen SIKS project, Denmark, 165
costs
of COPD, 148–149
of drugs, 130–131, 133
of pathology tests, 275–276, 277
of stroke, 55
C-reactive protein (CRP) tests, 277, 282
crisis response teams, 105
crowding, emergency departments, 189, 194
CT (computerized tomography), 12, 71, 75, 235, 246, 248–251
data, digitized, 7–8, 223, 226–227
data security, 259, 260
day surgery, 218
death
from COPD, 147–148, 153
neonatal, 27
from stroke, 53–54
decisions, shared decision-making (SDM), 76, 213–215, 226
delirium units, 94–95
dementia, 55, 94–95, 98–100, 107, 252
demographics, 23–24, 85, 130
Denmark, Copenhagen SIKS project, 165
design of hospitals, 16–17
child friendly, 24–25
emergency departments, 194–195
imaging departments, 250–251, 252
neonatal intensive care units, 29–31
diabetes, 45–46, 269, 289
diagnostic centres, 253
diagnostics, 44, 60–61, 75, 169, 270–271 see also laboratory medicine
over-diagnosis, 124
dietetics, 66
digital pathology, 260
digitized data, 7–8, 223, 226–227
disabilities, due to stroke, 54–55
discharge
care bundle project, COPD, London, 163–164
discharge-to-assess schemes, 101
early supported, 57, 63–64, 101–102, 162, 290
from emergency departments, 189–190
disease, chronicsee chronic disease
doctors, senior, 190–191
drugs, 72, 130–131, 224
adverse reactions, 104–105
Early Supported Discharge (ESD)
after stroke, 57, 63–64, 290
COPD, 162
older patients, 101–102
echocardiography, 71, 245
economicssee costs
educationsee training
eHealth initiatives, 135
elderly patientssee older patients
emergency medicine, 14–15, 45, 181–196
development of, and definition, 182–183
entering the emergency department, 184–186
hospital emergency departments, 186–189
admission / discharge, 189–190
workforce, 190–192
managing demand, 192–195
future trends, 195–196
geriatric and frailty services, 93–94
empowerment, patient, 134–135, 214, 226
end of life care, 62–63, 97–98, 102–103, 158, 196 see also palliative care
enhanced recovery programmes (ERP), 215–217, 226
equipment, imaging, 248–249, 255
errors, medical, 224
European Association for Children in Hospital (EACH), 38–39
European Cancer Organization (ECCO), 138
European Reference networks (ERNs), 137
evidence-based medicine, 55–59, 73
exercise physiologists, 167
exercise therapy, 213
extracorporeal membrane oxygenation (ECMO), 33
falls, 87–88, 96, 195
FAST (Face Arm Speech Time), 60
financial costssee costs
fitness, for surgery, 210–212
flow, of patients, 189
fractures, 95–96
frailty, 5, 13, 86–88, 195 see also older patients
Acute Frailty services, 93–94
France, Institut Gustaphe Roussy, Paris, 134
funding, 8–9, 249, 255–256
Gartner-Hype cycle, 260
gastrointestinal haemorrhage, 237
gene expression profiling, 44
generalists and specialists, 292–293
genome sequencing, 100 000 Genomes Project, 263–264
genomics, 260
geriatricians, 103–105, 106–108, 191, 209–210
geriatricssee older patients
Germany, organization of cancer care, 138
Gustaphe Roussy Institut, Paris, 134
Guy’s and St Thomas’ NHS Foundation Trust, POPS team, 209–210
haemorrhage, 237
haemorrhagic stroke, 54
health and safety, 195
health workerssee staff
hip fractures, 95–96
hip replacements, 204, 217
HIV, 5, 289
home-based care 102–3, 104, 105, 227
hospital admissions, prevention, 155–157
hospital at home schemes, 102–103, 104
Hospital Elder Life Programme (HELP), 95
hospitalists, 292–293
hospitals
challenges for future, 288–297
designsee design of hospitals
history of, 3–6
within wider health system, 9–10, 296
human factors and systems design, 224
Hyperacute Stroke Units (HASUs), 67
imaging, 15–16, 233–256
scope, 233–238
links with other services, 238–243
workforce, 243–245, 247–248, 254–255
use of, 245–247
equipment, 248–249, 255
funding issues, 249, 256
organization and imaging service location, 250–251, 252–253
future trends, 251–256
imaging guidance 131, 133–4, 252
and stroke, 60–61, 71, 75
immunotherapy, 124, 132–133
improvement science, 224–226, 227
infection control, in neonatal intensive care, 30–31
infectious disease, 43–44
information technology, 46, 47, 108, 135, 295 see also communications technology
in laboratory medicine, 276–277
in radiology / imaging, 235–237
wearable, 259, 281–282
innovation, 277, 296
Institut Gustaphe Roussy, Paris, 134
insulin pumps, 45–46
integrated care, 293–294
for older people, 108–109
perioperative care, 207–208
Integrated Respiratory Team (IRT), Kings Health Partners, London, 155–156
intermediate care services, 91–92, 105
internet, 163, 228
interventional radiology, 16, 237–238, 240, 242, 252, 253
Irish National Cancer Control Programme, 266–267
ischaemic stroke, 54, 57, 60, 73, 75
Italy
cancer networks, 137
Italian Association of Cancer Registries (AIRTUM), 139
Kehlet, Henrik, 216
ketoacidosis, 45
Kings Health Partners Integrated Respiratory Team, London, UK, 155–156
laboratory medicine, 16, 258–285
advances, 261–264
within hospitals, 265–267
in primary care, 267–269
workforce, 270–273, 275
workload, increasing, 274
barriers to optimal services, 273–277
future, 278–285
length of stay, 9, 204–205, 294
liaison
geriatric-surgical, 95–96
psychiatry, 99–100
life support, 33
lifestyle modification, 212–213
light, in neonatal intensive care, 31
London, UK
COPD discharge care bundle project, 163–164
Integrated Respiratory Team, Kings Health Partners, 155–156
POPS team, Guy’s and St Thomas’ NHS Foundation Trust, 209–210
long-term oxygen therapy (LTOT), 152
lung transplantation, 152, 169
lung volume reduction surgery (LVRS), 154, 169
magnetic resonance imaging (MRI), 233–235, 243, 246, 248–251
medical errors, 224
meetings, 129, 240, 297
mental health problems, 98–100, 188–189
Minor Injury Units, 185
molecular imaging, 235, 236
mortality
from COPD, 147–148, 153
neonatal, 27
from stroke, 53–54
MRI (magnetic resonance imaging), 233–235, 243, 246, 248–251
multidisciplinary teams, 241, 266, 291–292
cancer care, 127–129, 240
COPD, 155–156
perioperative care 208, 209–17, 220
stroke, 64–65, 76, 77
multimorbidity, 5, 64, 291, 292
near-patient testing, 6, 16, 191, 259
neonatal care, 11, 27–34
levels, 31–33
mortality, 27
neonatal intensive care units (NICU), 29–33
training, 34
trends, 27–29
The Netherlands
anaesthetic nurses, 219
cancer networks, 136
networks, 294
cancer, 135–137, 139
imaging, 254
laboratory medicine, 261
neurosurgery, 71
newbornssee neonatal care
NICU (neonatal intensive care units), 29–33
noise, in neonatal intensive care, 31
nurses
Advanced Nurse Practitioners, 107
anaesthetic nurses, 219
dementia, 100
emergency nurse practitioners, 191
neonatal, 33
physician associates, 167
shortages, 106–107
stroke, 65
nursing homes, 193
obesity, 255
observation wards, 188
obstetrics, 11, 27–29 see also neonatal care
older patients, 5, 12–13, 85–110, 195, 205–206 see also geriatricians
challenges, 85–89
pre-hospital care, 89–92
hospital care, 92–100
Acute Frailty services, 93–94
Comprehensive Geriatric Assessment, 92–93, 209–210
delirium / dementia, 94–95
end of life care, 97–98
outpatient clinics, 96–97
post-hospital care, 100–105
community geriatricians, 103–105
discharge, 101–102
hospital at home schemes, 102–103, 104
intermediate care rehabilitation services, 91–92, 105
medical staff, 106–108
barriers to delivering integrated care, 108–109
oncologysee cancer
online services, 163, 228
operating theatres, 15, 227–228 see also perioperative medicine
Organization of European Cancer Institutes (OECI), 138
orthogeriatric collaboration, 95–96
outpatient clinics, 96–97 see also ambulatory care
overcrowding, in emergency departments, 189, 194
oxygen therapy, 152
PACS (picture archiving and communication systems), 236–237, 244, 254, 255
paediatricians, 11, 31–33, 42
paediatricssee child health care
palliative care, 33, 60, 62–63 see also end of life care
paramedics, 15, 45, 185
parents, 34, 38
Paris, Institut Gustaphe Roussy, 136
pathologysee laboratory medicine
patient empowerment 134–5, 214, 226
patient flow, 189
patient registries, 138–139
patient safety, 8, 26, 34, 212, 283
patient-centred care, 10, 134–135, 209, 213–215
perioperative medicine, 15, 203–228
scope, 203–206
role, 206–209
multidisciplinary assessment, 209–217
ambulatory surgery, 218
workforce and training, 218–221
barriers to delivery, 221–222
advances in technology, 222–224
research, improvement science and the future, 224–228
personalized medicine 258–9, 264
person-centred care, 10, 134–135, 209, 213–215
PET-CT (positron emission tomography), 235, 251–252
pharmaceuticals, 72, 130–131, 224
adverse drug reactions, 104–105
pharmacists, 66
phones, 288–289
physiotherapy specialists, 167
picture archiving and communication systems (PACS), 236–237, 244, 254, 255
pneumonia, 43–44, 62
point of care testing (POCT),29, 72, 259, 262, 268–269, 271, 280–281
biosensors, 282–283
poison control centres, 45
POPS team (Proactive care of Older people undergoing Surgery), 209–210
population
ageing, 5, 205
child, 23–24
population health systems, 263
positron emission tomography (PET-CT), 235, 251–252
post-operative care, 15, 209, 215–217
postpartum haemorrhage, 237
pre-assessment clinics, 211–212
precision medicine, 132–133
pregnancies, 11, 28 see also neonatal care
prehabilitation, 212–213
premature babies, 11, 27, 29–33
prevention
accident, 195
cancer, 123–124
of hospital admissions, 155–157
secondary, 58, 189
primary care
for chronic diseases, 153, 293
emergency medicine, 185–186, 187, 192
and imaging, 242–243, 255
and laboratory medicine, 267–269
for older people, 89–92
Proactive care of Older people undergoing Surgery (POPS) team, 209–210
psychiatry, older people, 99–100
psychologists, 66
public health programmes, 74
pulmonary rehabilitation, 164–166
quality improvement (QI), 225–226, 266–267
quality of care, 8
COPD, 171
pathology, 275–276
stroke, 68–69, 70, 78
queues, in emergency departments, 194
radiation exposure, 248, 251
radiographers, 244–245, 247, 255
radiologists, 243, 247–248, 254–255
radiology, 15–16, 131–132, 233, 235–236, 276 see also imaging
interventional, 16, 237–238, 240, 242, 252, 253
radiotherapy, 131, 133
rapid response teams, 89–90, 105
recovery, 64, 215–217
registries, patient, 138–139
rehabilitation
after stroke, 56, 58–59, 63–64, 65–66, 73, 75
COPD, 164–166
for older patients, 105
reimbursement schemes, for drugs, 130–131
remote areas, patients in, 295
remote working, 227–228, 259–260
renal obstruction, 238
re-perfusion, 57
research, 224, 253–254, 271, 278
residential homes, 193
respiratory acidosis, 158, 168
respiratory nurses, 167
resuscitation, 29, 187
risk assessment and shared decision-making, 213–215
risk optimization, 212–213
road safety, 195
robotics, 75, 77, 227–228
safety, patient, 8, 26, 34, 212, 283
scientists, roles in cellular pathology, 272–273
screening, 124, 125
secondary prevention, 58, 189
self-management, chronic obstructive pulmonary disease, 155–156
self-testing, 259, 280–281
senior doctors, 190–191
shared decision-making (SDM), 76, 213–215, 226
shortages of staffsee staff shortages
SIKS project, Copenhagen, Denmark, 165
simulation, 34
smart phones, 288–289
smoking, 120, 123, 148–151
social care, 6, 108
Spain, Barcelona, telehealth team, 163
specialists and generalists, 292–293
staff, 17, 296
COPD, 166–168
emergency departments, 190–192
imaging, 243–245, 247–248, 254–255
laboratory medicine, 270–273, 275
perioperative care, 218–221
stroke care, 64–66, 72
staff shortages
cancer care, 130
emergency departments, 190
geriatrics, 247–248
perioperative care, 221
radiology, 247–248
stroke care, 72
stem cell technologies, 75
stress, 192
stroke, 12, 53–78, 238
burden of, 53–55
types of, 54
before hospital admission, 59–60
care in hospital, 60–63
rehabilitation and long-term management, 58–59, 63–64, 65–66, 73, 75
re-perfusion, 57
secondary prevention, 58
stroke units 56, 61, 67, 69, 77, 290
comprehensive stroke centres, 66–67
medical staff, 64–66, 72
networks of stroke care, 66–68
variation in care quality, 68–69, 70
specialist resources, 69, 71–72
barriers to optimal care, 72–74
the future, 74–78
sugammadex, 224
surgery, 132, 133 see also perioperative medicine
ambulatory, 218
assessing fitness for, 210–212
for COPD, 153–154, 169
enhanced recovery programmes, 215–217
surgical assessment units, 189
surgical liaison, 96
survival rates, cancer, 134–135
swallowing problems, after stroke, 62
Sweden, anaesthetic nurses, 219
symptoms, of stroke, 60
targeted therapies, 132–133
teamssee multidisciplinary teams
technology, advances, 44, 45–46, 133–134, 209, 222–224, 288–289
laboratory medicine, 259–260, 262
technology, communications, 156, 228, 289, 294 see also information technology
telemedicine, 44, 47, 67–68, 162–163
teleconsultations, 45, 227
telepathology, 259–260
teleradiology, 237
telephone advice lines, 184, 192–193
testing
fitness for surgery, 210–212
near-patient, 6, 16, 191, 259
point of care 29, 72, 259, 262, 268–269, 271, 280–281, 282–283
self, 259, 280–281
Theranos, company, 283
thrombectomy, 57, 61, 74, 75, 252
thrombolysis, 57, 61, 68, 73, 238
tobacco control, 120, 123, 148–151
Torbay Hospital clinic, 215
training
coaching, 226
for emergencies, 45
geriatrics, 106–108
neonatal care, 34
paediatric subspecialties, 40–41
perioperative care, 220–221
for stroke care, 72, 77
transient ischaemic attack (TIA), 54, 58, 60
transplants, lung, 152, 169
trauma services, 187–188
triage, 60, 185, 186–187
ultrasound, 71, 224, 233, 234–235, 244–245, 288–289
United Kingdom
COPD discharge care bundle project, 163–164
Integrated Respiratory Team, Kings Health Partners, 155–156
Physician’s Assistant (Anaesthesia), 219–220
POPS team, Guy’s and St Thomas’ NHS Foundation Trust, 209–210
vaccines, 123–124
vascular ultrasound, 71
ventilation, 32, 152, 158, 168–169
viral infections, as cause of cancer, 123–124
virtual clinics, 156
virtual community wards 102–3, 104
wearables, 259, 281–282
workforcesee staff
working hours, 34
X-rays, 233, 234–236, 251

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  • Index
  • Edited by Martin McKee, London School of Hygiene and Tropical Medicine, Sherry Merkur, Nigel Edwards, Ellen Nolte, London School of Hygiene and Tropical Medicine
  • Assisted by Jonathan North
  • Book: The Changing Role of the Hospital in European Health Systems
  • Online publication: 01 July 2020
  • Chapter DOI: https://doi.org/10.1017/9781108855440.012
Available formats
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  • Index
  • Edited by Martin McKee, London School of Hygiene and Tropical Medicine, Sherry Merkur, Nigel Edwards, Ellen Nolte, London School of Hygiene and Tropical Medicine
  • Assisted by Jonathan North
  • Book: The Changing Role of the Hospital in European Health Systems
  • Online publication: 01 July 2020
  • Chapter DOI: https://doi.org/10.1017/9781108855440.012
Available formats
×

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  • Index
  • Edited by Martin McKee, London School of Hygiene and Tropical Medicine, Sherry Merkur, Nigel Edwards, Ellen Nolte, London School of Hygiene and Tropical Medicine
  • Assisted by Jonathan North
  • Book: The Changing Role of the Hospital in European Health Systems
  • Online publication: 01 July 2020
  • Chapter DOI: https://doi.org/10.1017/9781108855440.012
Available formats
×