Hospital at home for acute medical illness: The 21st century acute medical unit for a changing population

Out-of-hospital-treatment in the form of a hospital at home has been suggested as a potential alternative to hospital admission. The objectives of the study were to address the feasibility of a hospital at home supported by telemedicine for older patients requiring admission. Of 601 patients screened, seven were eligible and willing to participate in the intervention. Poor health status and skepticism towards the technology was the main reasons for ineligibility and declining to take part. Patients admitted to the scheme at home felt safe and were positive regarding several aspects of the scheme. Health care professionals found that the intervention gave an opportunity to create a patient-centred treatment. However, the intervention was not successfully integrated because of the few cases. The economic evaluation found the cost of home admission depended on the turnover of patients. Hospital at home was not feasible in this setup and do not justify proceeding to a randomised controlled trial.

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696 Hospital at home: descriptive study of patients with chronic heart failure (CrHF) attended at home

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80447-9 ◽

2006 ◽

Vol 5 (1) ◽

pp. 158-159

Author(s):

J GUILLAMONT ◽

A SOLE ◽

S GONZALEZ ◽

A PEREZITURRIAGA ◽

C DAVILA ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Descriptive Study ◽

Hospital At Home ◽

At Home

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Hospital at home in chronic obstructive pulmonary disease: Is it a viable option?

10.1002/14651858.ed000042 ◽

2012 ◽

Author(s):

Sasha Sheppard ◽

Christopher Cates

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Viable Option ◽

Obstructive Pulmonary Disease ◽

Hospital At Home ◽

At Home

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Acute medical unit clinical skills lab

Future Healthcare Journal ◽

10.7861/futurehosp.6-1-s140 ◽

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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Clinical and Economic Impact of Medication Reconciliation by Designated Ward Pharmacists in a Hospitalist-Managed Acute Medical Unit

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2021.06.005 ◽

2021 ◽

Author(s):

Bogeum Park ◽

Anna Baek ◽

Yoonhee Kim ◽

Yewon Suh ◽

Jungwha Lee ◽

...

Keyword(s):

Economic Impact ◽

Medication Reconciliation ◽

Medical Unit ◽

Acute Medical Unit

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Causes of discharge delays from the acute medical unit (AMU) in a tertiary level teaching hospital, Brunei Darussalam

Proceedings of Singapore Healthcare ◽

10.1177/20101058211006143 ◽

2021 ◽

pp. 201010582110061

Author(s):

Dayang Nur Hilmiyah binti Awang Husaini ◽

Justin Fook Siong Keasberry ◽

Khadizah Haji Abdul Mumin ◽

Hanif Abdul Rahman

Keyword(s):

Observational Study ◽

Discharge Planning ◽

Patient Factors ◽

Medical Unit ◽

Prolonged Length ◽

Acute Medical Unit ◽

Brunei Darussalam ◽

Medical Issues ◽

Hospital Factors ◽

Prolonged Hospital

Background: Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance. Objectives: The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei. Methods: A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations. Results: A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%). Conclusions: There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.

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