Virtual wards for people with frailty: what works, for whom, how and why-a rapid realist review.

Background: Virtual wards (VWs) deliver multidisciplinary care at home to people with frailty who are at high risk of a crisis or in crisis, aiming to mitigate the risk of acute hospital admission. Different VW models exist, and evidence of effectiveness is inconsistent.

Aim: We conducted a rapid realist review to identify different VW models and to develop explanations for how and why VWs could deliver effective frailty management.

Implementation of the National Early Warning Score in patients with suspicion of sepsis: evaluation of a system-wide quality improvement project.

Background: The National Early Warning Score (NEWS) was introduced to standardise early warning scores (EWS) in England. It has been recommended that NEWS should be used in pre-hospital care but there is no published evidence that this improves outcomes. In 2015, the West of England Academic Health Science Network region standardised to NEWS across all healthcare settings.

Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England.

Objectives: Early warning scores were developed to improve recognition of clinical deterioration in acute hospital settings. In England, the National Early Warning Score (NEWS) is increasingly being recommended at a national level for use outside such settings. In 2015, the West of England Academic Health Science Network supported the roll-out of NEWS across a range of non-acute-hospital healthcare sectors.

Can early warning scores identify deteriorating patients in pre-hospital settings? A systematic review.

Objective: To evaluate the effectiveness and predictive accuracy of early warning scores (EWS) to predict deteriorating patients in pre-hospital settings.

Methods: Systematic review. Seven databases searched to August 2017.