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

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.

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Emergency Department Ceiling Collapse: Response to an Internal Emergency

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.133 ◽

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)

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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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Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.12.020 ◽

2021 ◽

Vol 41 ◽

pp. 208-216 ◽

Cited By ~ 1

Author(s):

Maria Dissing Olesen ◽

Robert Mariusz Modlinski ◽

Simon Hosbond Poulsen ◽

Pernille Mølgaard Rosenvinge ◽

Henrik Højgaard Rasmussen ◽

...

Keyword(s):

Risk Factors ◽

Geriatric Patients ◽

Medical Unit ◽

Acute Medical Unit ◽

Associated Risk Factors

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Acute medical unit staffing mismatch

Future Healthcare Journal ◽

10.7861/futurehosp.6-1-s44 ◽

2019 ◽

Vol 6 (Suppl 1) ◽

pp. 44-44

Author(s):

Dominic Reynish

Keyword(s):

Medical Unit ◽

Acute Medical Unit

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Socialising Disease: Medical Categories and Inclusion of the Aged

The Sociological Review ◽

10.1111/1467-954x.00222 ◽

2000 ◽

Vol 48 (3) ◽

pp. 383-407 ◽

Cited By ~ 11

Author(s):

Joanna Latimer

Keyword(s):

Older People ◽

Hospital Care ◽

Social Inclusion ◽

Social Problems ◽

Older Person ◽

Medical Unit ◽

Life Chances ◽

Acute Medical Unit ◽

Medical Domain

When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.

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