scholarly journals A swift and dynamic strategy to expand emergency department capacity for COVID-19

2020 ◽  
pp. 1-13
Author(s):  
Dennis Gerard Barten ◽  
Renske Wilhelmina Johanna Kusters ◽  
Nathalie Antoinne La Reine Peters
Keyword(s):  
Emergency Department ◽  
Emergency Care ◽  
Potential Model ◽  
Risk Area ◽  
Hospital Size ◽  
Medical Unit ◽  
Expansion Strategy ◽  
Local Factors ◽  
Acute Medical Unit ◽  
Dynamic Strategy

ABSTRACT Emergency departments (EDs) worldwide struggled to prepare for COVID-19 patient surge and to simultaneously preserve sufficient capacity for ‘regular’ emergency care. While many hospitals used costly shelter facilities, it was decided to merge the acute medical unit (AMU) and the ED. The conjoined AMU-ED was segregated into a high-risk and a low-risk area to maintain continuity of emergency care. This strategy allowed for a feasible, swift and dynamic expansion of ED capacity without the need for external tent facilities. This report details on the technical execution and discusses the pearls and potential pitfalls of this expansion strategy. Although ED preparedness for pandemics may be determined by local factors such as hospital size, ED census and primary healthcare efficacy, the conjoined AMU-ED strategy may be a potential model for other EDs.

Emergency Department Ceiling Collapse: Response to an Internal Emergency

2019 ◽  
Vol 13 (4) ◽  
pp. 829-830
Author(s):  
Dennis G. Barten ◽  
Matthijs T. W. Veltmeijer ◽  
Nathalie A. L. R. Peters
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Emergency Care ◽  
Medical Center ◽  
Disaster Resilience ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Unique Approach ◽  
External Events ◽  
Developed World

ABSTRACTHospital disaster resilience is often conceived as the ability to respond to external disasters. However, internal disasters appear to be more common events in hospitals than external events. This report describes the aftermath of a ceiling collapse in the emergency department of VieCuri Medical Center in Venlo, the Netherlands, on May 18, 2017. By designating the acute medical unit as a temporary emergency department, standard emergency care could be resumed within 8 hours. This unique approach might be transferrable to other hospitals in the developed world. In general, it is vital that hospital disaster plans focus on both external and internal disasters, including specific scenarios that disrupt vital hospital departments such as the emergency department. (Disaster Med Public Health Preparedness. 2019;13:829–830)

scholarly journals Using the principles of ‘same day emergency care’ in our new acute medical unit

2020 ◽  
Vol 7 (Suppl 1) ◽  
pp. s81-s81
Author(s):  
Shaznin Visanji ◽  
Holly Lyne ◽  
Alexandra Phillips ◽  
Hazel Gilbert ◽  
Zachary Ferguson ◽  
...  
Keyword(s):  
Emergency Care ◽  
Medical Unit ◽  
Acute Medical Unit

The effect of context on performance of an acute medical unit: experience from an Australian tertiary hospital

2012 ◽  
Vol 36 (3) ◽  
pp. 320 ◽  
Author(s):  
Belinda Suthers ◽  
Robert Pickles ◽  
Michael Boyle ◽  
Kichu Nair ◽  
Justyn Cook ◽  
...  
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Local Context ◽  
Health Staff ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Transfers Of Care

Objective. To ascertain the improvements in length of stay and discharge rates following the opening of an acute medical unit (AMU). Methods. Retrospective cohort study of all patients admitted under general medicine from June–November 2008. Main outcome measures were length of stay in hospital and in the emergency department (ED). Results. The length of time spent in the emergency department for those admitted to the AMU was significantly shorter than those admitted directly to a medical ward (6.83 h v. 9.40 h, P < 0.0001). A trend towards shorter hospital length of stay continued after the AMU opened compared with the same period in the previous year (5.15 days (2.49, 11.57 CI) v. 5.66 days (2.76, 11.52 CI)). However, the number of ward transfers for a patient and the need to wait for a nursing home bed or public rehabilitation affected length of stay much more than the AMU. Conclusion. An AMU was successful in decreasing ED length of stay and contributed to decreasing hospital length of stay. However, we suggest that local context is crucially important in tailoring an AMU to obtain maximal benefit, and that AMUs are not a ‘one size fits all’ solution. What is known about the topic? Acute Medical Units were pioneered in the UK and have been shown to decrease length of stay with no increase in adverse events. As a result, they have been enthusiastically adopted in Australia. However, most studies have been single point ‘before/after’ designs looking at all medical patients, and there has been little consideration of the context in which AMUs operate and how this might affect their performance. What does this paper add? We consider length of stay trends over many years and separate single organ disease from multi-system disease patients, in order to ensure that gains are not simply a result of selective entry of healthier patients into AMUs. We also show that the effect of an AMU is small compared with other systemic issues, such as waiting for nursing home placement and the number of transfers of care. What are the implications for practitioners? Although there may be gains in terms of length of stay in the emergency department, those considering the establishment of an AMU need to consider other factors that may mitigate the improvements in hospital length of stay, such as the roadblocks to discharge, the organisation of allied health staff, and the number of transfers of care.

scholarly journals Sort and Sieve: Pre-Triage Screening of Patients with Suspected COVID-19 in the Emergency Department

2021 ◽  
Vol 18 (17) ◽  
pp. 9271
Author(s):  
Kirsten R.C. Hensgens ◽  
Inge H.T. van Rensen ◽  
Anita W. Lekx ◽  
Frits H.M. van Osch ◽  
Lieve H.H. Knarren ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Primary Outcome ◽  
Screening Method ◽  
Single Centre ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Single Centre Study ◽  
Screening Accuracy ◽  
Specific Symptoms

Introduction. To reduce the risk of nosocomial transmission, suspected COVID-19 patients entering the Emergency Department (ED) were assigned to a high-risk (ED) or low-risk (acute medical unit, AMU) area based on symptoms, travel and contact history. The objective of this study was to evaluate the performance of our pre-triage screening method and to analyse the characteristics of initially undetected COVID-19 patients. Methods. This was a retrospective, observational, single centre study. Patients ≥ 18 years visiting the AMU-ED between 17 March and 17 April 2020 were included. Primary outcome was the (correct) number of COVID-19 patients assigned to the AMU or ED. Results. In total, 1287 patients visited the AMU-ED: 525 (40.8%) AMU, 762 (59.2%) ED. Within the ED group, 304 (64.3%) of 473 tested patients were COVID-19 positive, compared to 13 (46.4%) of 28 tested patients in the AMU group. Our pre-triage screening accuracy was 63.7%. Of the 13 COVID-19 patients who were initially assigned to the AMU, all patients were ≥65 years of age and the majority presented with gastro-intestinal or non-specific symptoms. Conclusion. Older COVID-19 patients presenting with non-specific symptoms were more likely to remain undetected. ED screening protocols should therefore also include non-specific symptoms, particularly in older patients.

scholarly journals The Acute Medicine – Speciality Interface: Experience in a District General Hospital

2011 ◽  
Vol 10 (2) ◽  
pp. 89-90
Author(s):  
Charlotte Cannon ◽  
Keyword(s):  
Emergency Department ◽  
General Hospital ◽  
District General Hospital ◽  
Acute Medicine ◽  
Medical Unit ◽  
Princess Margaret Hospital ◽  
Western Hospital ◽  
Acute Medical Unit ◽  
Close Proximity

The Great Western Hospital was opened in 2002. It was built as a PFI hospital, moving services from the old Princess Margaret Hospital situated in central Swindon. The Great Western Hospital is conveniently situated near junction 15 of the M4 and therefore has excellent transport links. The Acute Medical Unit (AMU) was purpose built adjacent to the Emergency Department and in close proximity to Emergency Department Radiology. Details of the Acute Medical Unit layout are summarised in Table 2.

An Accident and Emergency Department's View of Self-poisoning: a Retrospective Study from the United Norwich Hospitals 1978-1982

1986 ◽  
Vol 5 (1) ◽  
pp. 5-10 ◽  
Author(s):  
R.H.M. Adams
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Hospital Admissions ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Accident And Emergency ◽  
Accident And Emergency Department

This 5-year review of deliberate self-poisoning cases seen in an accident and emergency department revealed that about 700 patients were seen per year. Three-quarters of these needed admission (forming some 15% of all hospital admissions). Of these 65% were referred to the psychiatrist. The remaining quarter were dealt with in the accident and emergency department. Analysis of the data identifies problems where further research is needed. In particular the question is raised as to whether these patients would not be better dealt with in an acute medical unit now that accident departments are turning their attention increasingly to the management of trauma.

scholarly journals Acute medical unit clinical skills lab

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 140-140
Author(s):  
Sarb Clare ◽  
Joe Wheeler
Keyword(s):  
Clinical Skills ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Skills Lab
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