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The World Federation of Societies of Anesthesioologists (WFSA) is a federation of some 76 anesthesia societies throughout the world. Our role in the management of disasters is very minimal; in fact, we have no specific service role. It does have a role to play in education and research aspects of acute medicine. The World Federation's aims are those of education of anesthesiologists of our member societies. This educational role is fulfilled by the staging of meetings, by the foundation of training centers in anesthesiology, by the production of special manuals and by meeting some of the expenses of visiting educational teams that travel to various parts of the world as visiting professors. These are all educational functions. Included in this function, of course, would be education in emergency medicine and disaster medicine.

This work represents a collection of articles given during the 15th Annual Symposium on Acute Medicine held by the University of Southern California. The authors include many persons important in the development and current practice of intensive care and acute care medicine. Several chapters are short, and the titles may promise more than is delivered. Examples of the latter might include "Techniques on Monitoring Intracranial Pressure." The chapter on "Total Parenteral Nutrition in the Critically Ill" presents an excellent review of this important subject. Almost all of the material is repeated from the various author's original work, with little that can be considered new or original. However, the extensive list of references will allow those who are so motivated to pursue these topics in greater depth. Finally, the addition of pertinent questions at the end of the book follows the current format for teaching instruments in the field of medicine.

Timely medical assessment is integral to the safety and quality of healthcare delivery in acute medicine. Medical staff are an expensive resource. This study aimed to develop a modelling system that facilitated efficient workforce planning according to patient need on the acute medical unit. A realistic 24-hour ‘supply’ of junior doctors was calculated by adjusting the theoretical numbers on the rota for leave allowances, natural breaks and other ward duties by a combination of direct observation of working practice and junior doctor interviews. ‘Demand’ was analysed using detailed admission data. Supply and demand were then integrated with data from a survey of the time spent on the process of clerking and assessment of medical admissions. A robust modelling system that predicted the number of unclerked patients was developed. The utility of the model was assessed by demonstrating the impact of a regulation-compliant redesign of the rota using existing staff and by predicting the most efficient use of an additional shift. This simple modelling system has the potential to enhance quality of care and efficiency by linking workforce planning to patient need.

In 2007, the Acute Medicine Task Force made recommendations about the operation and staffing of acute medical units (AMU). Consultant-led care was seen as critical to ensuring high standards of care for patients and maintaining efficient patient flow [1]. It also recommended that during the hours when the AMU is staffed by a consultant, all new patients should be seen within 6 to 8 hours. Patients admitted overnight should have a consultant review within 12 to 14 hours. Following the Introduction of a 4:00 pm consultant ward round of newly admitted acute medical patients to the existing 8:00 am and 2:00 pm rounds, it was our intention to establish whether our trust was meeting those recommendations.