Kit Byatt
@kitb.bsky.social
Retired geriatrician, now working in human rights medicine & med ed; EBM; patient-centred care; equity & justice; curious about the world and its people; usually optimistic.
Refugee from Twitter (@Laconic_doc)!
Refugee from Twitter (@Laconic_doc)!
Pinned
Kit Byatt
@kitb.bsky.social
· Sep 25
I've devised a model for analysis of unplanned hospital bed use.
I am looking for some NHS clinical/managerial decision-makers to interview about your thoughts on this.
Get in touch!
papers.ssrn.com/sol3/papers....
A Compartmental Model to Describe Acute Medical In-Patient Flow Through a Hospital
Health care is becoming increasingly complex, especially in secondary care. Hospital bed numbers per capita in the United Kingdom (UK) are lower than many Europ
papers.ssrn.com
We have now moved onto the next phase of using som real-world data to test the model.
Watch this space!
Watch this space!
Reposted by Kit Byatt
No. That is not the law. A state needs to have an effective government to be a state. It does not need to have a strong army. Costa Rica abolished its army a long time ago - that does not mean you can now just seize it.
Miller: Denmark is a tiny country with a tiny economy and a tiny military. They cannot defend Greenland… Under every understanding of law that has existed about territorial control for 500 years, to control a territory you have to be able to defend a territory…
January 17, 2026 at 8:23 AM
No. That is not the law. A state needs to have an effective government to be a state. It does not need to have a strong army. Costa Rica abolished its army a long time ago - that does not mean you can now just seize it.
Reposted by Kit Byatt
Kyiv.
One more video of the frozen Dnipro River for you.
This one made me smile.
People here don’t lose their sense of humour even in such hard times (or maybe it was a long-held dream to lie on the Dnipro 😉).
One more video of the frozen Dnipro River for you.
This one made me smile.
People here don’t lose their sense of humour even in such hard times (or maybe it was a long-held dream to lie on the Dnipro 😉).
January 17, 2026 at 7:00 PM
Kyiv.
One more video of the frozen Dnipro River for you.
This one made me smile.
People here don’t lose their sense of humour even in such hard times (or maybe it was a long-held dream to lie on the Dnipro 😉).
One more video of the frozen Dnipro River for you.
This one made me smile.
People here don’t lose their sense of humour even in such hard times (or maybe it was a long-held dream to lie on the Dnipro 😉).
Thank you for still being creative, open to beauty, and able to smile...
Despite everything!
Despite everything!
January 17, 2026 at 7:52 PM
Thank you for still being creative, open to beauty, and able to smile...
Despite everything!
Despite everything!
CORRECTION:
Free extra days (FED) =
((B ‐ C)*D*5) + (G*E*6.7)
Free extra days (FED) =
((B ‐ C)*D*5) + (G*E*6.7)
January 17, 2026 at 7:06 PM
CORRECTION:
Free extra days (FED) =
((B ‐ C)*D*5) + (G*E*6.7)
Free extra days (FED) =
((B ‐ C)*D*5) + (G*E*6.7)
Not difficult to devise a simple 'average metric' for trusts,p based on:
A) admissions/yr;
B) % ≥65
C) % of those with dementia
D) mean LoS in population B
E) mean LoS in population C
F) A * B
G) A * B * C
Free extra days = (F*5)+ (G*1.7)
[I think!]
A) admissions/yr;
B) % ≥65
C) % of those with dementia
D) mean LoS in population B
E) mean LoS in population C
F) A * B
G) A * B * C
Free extra days = (F*5)+ (G*1.7)
[I think!]
January 17, 2026 at 3:13 PM
Not difficult to devise a simple 'average metric' for trusts,p based on:
A) admissions/yr;
B) % ≥65
C) % of those with dementia
D) mean LoS in population B
E) mean LoS in population C
F) A * B
G) A * B * C
Free extra days = (F*5)+ (G*1.7)
[I think!]
A) admissions/yr;
B) % ≥65
C) % of those with dementia
D) mean LoS in population B
E) mean LoS in population C
F) A * B
G) A * B * C
Free extra days = (F*5)+ (G*1.7)
[I think!]
Reposted by Kit Byatt
It cannot be claimed it was only Trump, or RFK Jr. All these politicians are trying to undermine reality. They do it the only way possible: by lying.
Why? To undermine reality, the truth that people experience. Then they can undermine it with "their thuth".
1/2
Why? To undermine reality, the truth that people experience. Then they can undermine it with "their thuth".
1/2
January 17, 2026 at 11:27 AM
It cannot be claimed it was only Trump, or RFK Jr. All these politicians are trying to undermine reality. They do it the only way possible: by lying.
Why? To undermine reality, the truth that people experience. Then they can undermine it with "their thuth".
1/2
Why? To undermine reality, the truth that people experience. Then they can undermine it with "their thuth".
1/2
Reposted by Kit Byatt
A ‘gold standard’ review has rejected President Trump’s assertions that taking the painkiller could cause learning disorders
No link between paracetamol use in pregnancy and autism, study finds
www.thetimes.com
January 17, 2026 at 11:32 AM
A ‘gold standard’ review has rejected President Trump’s assertions that taking the painkiller could cause learning disorders
Never forget the McNamara fallacy!!
The danger of making the measurable important, rather than the important measurable!
en.wikipedia.org/wiki/McNamar...
The danger of making the measurable important, rather than the important measurable!
en.wikipedia.org/wiki/McNamar...
McNamara fallacy - Wikipedia
en.wikipedia.org
January 17, 2026 at 11:11 AM
Never forget the McNamara fallacy!!
The danger of making the measurable important, rather than the important measurable!
en.wikipedia.org/wiki/McNamar...
The danger of making the measurable important, rather than the important measurable!
en.wikipedia.org/wiki/McNamar...
Reposted by Kit Byatt
Spot on Kit. Part of a discharge frontrunner project at the NCA has been about creating a specialist dementia ward (from a standard geriatric medicine ward) and getting people straight there from ED. @lindseydarley1.bsky.social can share more. And this paper shows why that's an important focus.
January 17, 2026 at 10:42 AM
Spot on Kit. Part of a discharge frontrunner project at the NCA has been about creating a specialist dementia ward (from a standard geriatric medicine ward) and getting people straight there from ED. @lindseydarley1.bsky.social can share more. And this paper shows why that's an important focus.
Bed days lost (aka 'free extra bed days'!) are a key metric for (bed) managers in a resource-strapped system.
This changes an emotional argument into a hard numbers (ie £) one which is relatively easy to conceptualise, discuss and operationalise, even if only at a very simple level.
This changes an emotional argument into a hard numbers (ie £) one which is relatively easy to conceptualise, discuss and operationalise, even if only at a very simple level.
January 17, 2026 at 10:35 AM
Bed days lost (aka 'free extra bed days'!) are a key metric for (bed) managers in a resource-strapped system.
This changes an emotional argument into a hard numbers (ie £) one which is relatively easy to conceptualise, discuss and operationalise, even if only at a very simple level.
This changes an emotional argument into a hard numbers (ie £) one which is relatively easy to conceptualise, discuss and operationalise, even if only at a very simple level.
Brilliant, much needed work, Emma. HT
You and the team did the heavy lifting—I'm always happy to promulgate good and important work!
You and the team did the heavy lifting—I'm always happy to promulgate good and important work!
January 17, 2026 at 10:19 AM
Brilliant, much needed work, Emma. HT
You and the team did the heavy lifting—I'm always happy to promulgate good and important work!
You and the team did the heavy lifting—I'm always happy to promulgate good and important work!
At least now we can quantify this well-recognised (by geriatricians, anyway!) effect and say to a board:
"Would you like n hundred extra bed days per year in this hospital, for free?"
"Would you like n hundred extra bed days per year in this hospital, for free?"
January 17, 2026 at 10:17 AM
At least now we can quantify this well-recognised (by geriatricians, anyway!) effect and say to a board:
"Would you like n hundred extra bed days per year in this hospital, for free?"
"Would you like n hundred extra bed days per year in this hospital, for free?"
Brilliant work, Emma!
I remember presenting to the board (as dementia lead) ~15 yrs ago re the qualitative deleterious impact (delirium) of bed moves in pts with dementia & asking for notes to have a 'dementia tag'.
Head:brick wall!
Maybe these quantitative data will motivate bed managers?!
I remember presenting to the board (as dementia lead) ~15 yrs ago re the qualitative deleterious impact (delirium) of bed moves in pts with dementia & asking for notes to have a 'dementia tag'.
Head:brick wall!
Maybe these quantitative data will motivate bed managers?!
January 17, 2026 at 9:59 AM
Brilliant work, Emma!
I remember presenting to the board (as dementia lead) ~15 yrs ago re the qualitative deleterious impact (delirium) of bed moves in pts with dementia & asking for notes to have a 'dementia tag'.
Head:brick wall!
Maybe these quantitative data will motivate bed managers?!
I remember presenting to the board (as dementia lead) ~15 yrs ago re the qualitative deleterious impact (delirium) of bed moves in pts with dementia & asking for notes to have a 'dementia tag'.
Head:brick wall!
Maybe these quantitative data will motivate bed managers?!
Key point:
In hospitalized older adults, each ward change increased length of stay by 5 days and a further 1.7 days for those with dementia.
How many ward changes per 100 patients in your average hospital?
For bed days lost, times that by:
• 5 for pts ≥65
• 6.7 in those w/ dementia (10%)
In hospitalized older adults, each ward change increased length of stay by 5 days and a further 1.7 days for those with dementia.
How many ward changes per 100 patients in your average hospital?
For bed days lost, times that by:
• 5 for pts ≥65
• 6.7 in those w/ dementia (10%)
![Screenshot of page 1 of cited paper:
'Do ward changes affect outcomes differently in people living with dementia?
E Elliott et al.
Abstract
Background: Ward changes during hospital admissions are associated with poorer outcomes, but their impact on people living with dementia is unknown.
Objective: To examine whether individuals with dementia are more adversely affected by ward changes.
Setting: Four hospitals within a UK NHS Trust. Subjects: Individuals aged ≥65 years.
Methods: This service evaluation included data from 01/2023–02/2024. Generalised estimating equations were used to fit linear and logistic regression models. Associations between ward changes, dementia status and their interaction on three outcomes—length of stay (LOS), inpatient mortality and discharged to a care home—were examined. Fully adjusted models
accounted for demographic, socioeconomic factors and hospital site.
Results: 27,140 admissions, 19,392 unique individuals (2760 with dementia) were included. Mean age at first admission 79.0 (SD 8.1). In the fully adjusted LOS model, both ward changes (β = 5.2, P < .001) and the interaction with dementia (β = 1.7, P < .001) were associated with longer LOS.
[truncated because of word count limit]
Conclusions: Our results suggest that ward changes disproportionately affect LOS, but not mortality or discharge destination, in people living with dementia. Minimising ward transfers may improve outcomes for all older adults but is particularly important in dementia care to reduce the risk of extended LOS and potential associated inpatient harm.
Key Points
• In hospitalized older adults, each ward change increased length of stay by 5 days and a further 1.7 days for those with dementia.
• There was no interaction between ward changes and dementia on mortality and new care home admission.
• Minimising ward changes should be prioritised in older adults and particularly in people living with dementia](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:q24olizdo2jyy2adtk3kkjg5/bafkreibphunhbjez3ja7tfcpyrsb7uobzmxkt2c3fqyolmgxy22b6rgwgu@jpeg)
January 17, 2026 at 9:51 AM
Key point:
In hospitalized older adults, each ward change increased length of stay by 5 days and a further 1.7 days for those with dementia.
How many ward changes per 100 patients in your average hospital?
For bed days lost, times that by:
• 5 for pts ≥65
• 6.7 in those w/ dementia (10%)
In hospitalized older adults, each ward change increased length of stay by 5 days and a further 1.7 days for those with dementia.
How many ward changes per 100 patients in your average hospital?
For bed days lost, times that by:
• 5 for pts ≥65
• 6.7 in those w/ dementia (10%)
Reposted by Kit Byatt
A ratio of 1:27 Russian loss in Kupiansk
….so for every 1 lost Ukrainian, 27 Russian soldiers killed or injured off the battlefield, with c 90% pf Kupiansk (in the northern Kharkiv region) now under Ukrainian control .
Not quite the story Putin tells.
apple.news/AJI4A3fv4RBe...
….so for every 1 lost Ukrainian, 27 Russian soldiers killed or injured off the battlefield, with c 90% pf Kupiansk (in the northern Kharkiv region) now under Ukrainian control .
Not quite the story Putin tells.
apple.news/AJI4A3fv4RBe...
Ukraine killed 27 Russian soldiers for every loss as it regained Kupiansk — The Independent
An intelligence assessment provided to the British military revealed a 1:27 kill ratio in the battle for Kupiansk, with 27 Russian soldiers lost for each Ukrainian.
apple.news
January 16, 2026 at 11:06 PM
A ratio of 1:27 Russian loss in Kupiansk
….so for every 1 lost Ukrainian, 27 Russian soldiers killed or injured off the battlefield, with c 90% pf Kupiansk (in the northern Kharkiv region) now under Ukrainian control .
Not quite the story Putin tells.
apple.news/AJI4A3fv4RBe...
….so for every 1 lost Ukrainian, 27 Russian soldiers killed or injured off the battlefield, with c 90% pf Kupiansk (in the northern Kharkiv region) now under Ukrainian control .
Not quite the story Putin tells.
apple.news/AJI4A3fv4RBe...
Reposted by Kit Byatt
Image is from an email from Institute for Neuro-Immune Medicine Center for Collaborative Research
Links from image:
www.cards2warriors.org
www.cards2warriors.org/happy-mail
#chronicillness #illness #Illhealth #ChronicIllnesses
#Spoonies #Spoonie #ChronicallyIll
Links from image:
www.cards2warriors.org
www.cards2warriors.org/happy-mail
#chronicillness #illness #Illhealth #ChronicIllnesses
#Spoonies #Spoonie #ChronicallyIll
January 17, 2026 at 1:35 AM
Image is from an email from Institute for Neuro-Immune Medicine Center for Collaborative Research
Links from image:
www.cards2warriors.org
www.cards2warriors.org/happy-mail
#chronicillness #illness #Illhealth #ChronicIllnesses
#Spoonies #Spoonie #ChronicallyIll
Links from image:
www.cards2warriors.org
www.cards2warriors.org/happy-mail
#chronicillness #illness #Illhealth #ChronicIllnesses
#Spoonies #Spoonie #ChronicallyIll
This is so true.
Senior decision-makers make their decision based on wide experience rather than less experienced ones for whom the old saw 'To a person with a hammer, everything is nail-shaped' tends to apply.
Senior decision-makers make their decision based on wide experience rather than less experienced ones for whom the old saw 'To a person with a hammer, everything is nail-shaped' tends to apply.
If only there were some kind of useful lesson here about deploying more senior skills in triage outside of strike periods
www.ft.com/content/c928...
www.ft.com/content/c928...
January 17, 2026 at 9:09 AM
This is so true.
Senior decision-makers make their decision based on wide experience rather than less experienced ones for whom the old saw 'To a person with a hammer, everything is nail-shaped' tends to apply.
Senior decision-makers make their decision based on wide experience rather than less experienced ones for whom the old saw 'To a person with a hammer, everything is nail-shaped' tends to apply.
Reposted by Kit Byatt
This photo was taken in 1911 using glass plate technology by Herbert Ponting who was part of Scott's Antarctic expedition,
The composition and detail are exquisite with the band of white snow/ice creating a perfect frame around the two people and the ship in the distance
Iconic imo
The composition and detail are exquisite with the band of white snow/ice creating a perfect frame around the two people and the ship in the distance
Iconic imo
January 17, 2026 at 7:12 AM
This photo was taken in 1911 using glass plate technology by Herbert Ponting who was part of Scott's Antarctic expedition,
The composition and detail are exquisite with the band of white snow/ice creating a perfect frame around the two people and the ship in the distance
Iconic imo
The composition and detail are exquisite with the band of white snow/ice creating a perfect frame around the two people and the ship in the distance
Iconic imo
Reposted by Kit Byatt
It will not surprise you to learn that Toby Youngs 'Free Speech Union' has obtained a High Court injunction banning the publication of a list of its donors open.substack.com/pub/democrac...
Who funds the Free Speech Union?
Toby Young’s outfit went to court to hide its donors. Today we reveal that funders include US anti-abortion groups, Brexit politicians and Tufton Street insiders.
open.substack.com
January 17, 2026 at 8:45 AM
It will not surprise you to learn that Toby Youngs 'Free Speech Union' has obtained a High Court injunction banning the publication of a list of its donors open.substack.com/pub/democrac...
Finding beauty amidst horror is your superpower, Yaroslava!
(keeping you in mind)
(keeping you in mind)
January 16, 2026 at 5:34 PM
Finding beauty amidst horror is your superpower, Yaroslava!
(keeping you in mind)
(keeping you in mind)
Reposted by Kit Byatt
No, this isn't Tehran. It's Minneapolis.
Some protesters have reported being hit with rubber bullets close to the scene of a reported shooting in north Minneapolis involving federal agents in the area of W. 25th Street and Lyndale Avenue N.
Federal agents have deployed chemical irritants. Updates here: bit.ly/4sI4z3q
Federal agents have deployed chemical irritants. Updates here: bit.ly/4sI4z3q
January 16, 2026 at 12:21 AM
No, this isn't Tehran. It's Minneapolis.
Reposted by Kit Byatt
Amid the energy crisis caused by russia, Kyiv keeps going.
Severe frost brought ice,
and today I saw the sidewalks being salted.
A small thing,
but it means the city is alive.
Severe frost brought ice,
and today I saw the sidewalks being salted.
A small thing,
but it means the city is alive.
January 16, 2026 at 5:29 PM
Amid the energy crisis caused by russia, Kyiv keeps going.
Severe frost brought ice,
and today I saw the sidewalks being salted.
A small thing,
but it means the city is alive.
Severe frost brought ice,
and today I saw the sidewalks being salted.
A small thing,
but it means the city is alive.
Small human actions trump cynical military action!
(Supporting you from afar!)
(Supporting you from afar!)
January 16, 2026 at 5:31 PM
Small human actions trump cynical military action!
(Supporting you from afar!)
(Supporting you from afar!)
January 16, 2026 at 5:29 PM
Reposted by Kit Byatt
Anyone read the new UKHSA guidelines on avian flu that came out yesterday? According to them if I have a cold and go to work, then because I have pet poultry I should be isolated,
swabbed & discussed with public health, and anyone near me in PPE (FFP3/gloves/gown/eye protection)…. N/1
swabbed & discussed with public health, and anyone near me in PPE (FFP3/gloves/gown/eye protection)…. N/1
January 16, 2026 at 5:19 PM
Anyone read the new UKHSA guidelines on avian flu that came out yesterday? According to them if I have a cold and go to work, then because I have pet poultry I should be isolated,
swabbed & discussed with public health, and anyone near me in PPE (FFP3/gloves/gown/eye protection)…. N/1
swabbed & discussed with public health, and anyone near me in PPE (FFP3/gloves/gown/eye protection)…. N/1