{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:06:43Z","timestamp":1790168803033,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T00:00:00Z","timestamp":1375401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We studied the management of patients with acute upper gastrointestinal (GI) bleeding (AUGIB) at the Royal Free Hospital. The aim was to compare our performance with the national standard and determine ways of improving the delivery of care in accordance with the recently published \u2018Scope for improvement\u2019 report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We randomly selected patients who presented with haematemesis, melaena, or both, and had an oesophageogastroduodenoscopy (OGD) between April and October 2009. We developed local guidelines and presented our findings in various forums. We collaborated with the\n                      <jats:italic toggle=\"yes\">British Medical Journal<\/jats:italic>\n                      \u2019s Evidence Centre and Cerner Millennium electronic patient record system to create an electronic \u2018Action Set\u2019 for the management of patients presenting with AUGIB. We re-audited using the same standard and target.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      With the action set, documentation of pre-OGD Rockall scores increased significantly (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2264 0.0001). The differences in the calculation and documentation of post-OGD full Rockall scores were also significant between the two audit loops (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.007). Patients who inappropriately received proton-pump inhibitors (PPIs) before endoscopy were reduced from 73.8% to 33% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.02). Patients receiving PPIs after OGD were also reduced from 66% to 50% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.01). Discharges of patients whose full Rockall score was less than or equal to two increased from 40% to 100% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The use of the Action Set improved calculation and documentation of risk scores and facilitated earlier hospital discharge for low-risk patients. Significant improvements were also seen in inappropriate use of PPIs. Actions sets can improve guideline adherence and can potentially promote cost-cutting and improve health economics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1756283x13496971","type":"journal-article","created":{"date-parts":[[2013,8,3]],"date-time":"2013-08-03T00:56:29Z","timestamp":1375491389000},"page":"426-437","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Using an \u2018action set\u2019 for the management of acute upper gastrointestinal bleeding"],"prefix":"10.1177","volume":"6","author":[{"given":"Marinos","family":"Pericleous","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Royal Free Hospital, London, 21 Tudor Close, London NW3 4AG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert","family":"Negus","sequence":"additional","affiliation":[{"name":"Department of Acute Medicine, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Peachey","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics and Critical Care, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Acute Medicine, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"O\u2019Beirne","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Royal Free Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,8,2]]},"reference":[{"key":"e_1_3_2_2_1","volume-title":"Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 2: Culture and Redesign)","author":"Ballard D.","year":"2008","unstructured":"Ballard D., Ogola G., Fleming N., Heck D., Gunderson J., Mehta R., et al. (2008) The impact of standardized order sets on quality and financial outcomes. In: Henriksen K., Battles J., Keyes M., Grady M. (eds), Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 2: Culture and Redesign). Rockville, MD: Agency for Healthcare Research and Quality."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzq051"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.30272.x"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7107.510"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/JAC.0b013e3181d91680"},{"key":"e_1_3_2_7_1","unstructured":"British Society of Gastroenterology (2007) UK Upper GI Bleeding Audit. UK Comparative Audit of Upper Gastrointestinal Bleeding and the Use of Blood. 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(2004) Proton pump inhibitor treatment for acute peptic ulcer bleeding. Cochrane Database Syst Rev 3: CD002094.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01865.x"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2006.04762.x"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.399"},{"key":"e_1_3_2_23_1","doi-asserted-by":"crossref","unstructured":"Palmer K. (2011) Scope for Improvement: A toolkit for a safer Upper Gastrointestinal Bleeding (UGIB) service. 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