Acute assessment units in hospitals: greater bed capacity, better patient care

Establishing acute assessment units in hospitals can significantly improve hospitals’ performance in key health care indicators without compromising the quality of patient care, according to research published in the Medical Journal of Australia.

Acute assessment units (AAUs) present a possible solution to the increasing number of acute medical admissions to major teaching hospitals with a restricted number of hospital inpatient beds, writes Dr Jordan Li, consultant physician at Flinders Medical Centre and Flinders University, SA, and his co-authors.

The authors conducted a retrospective comparison of data for general medical patients admitted to Flinders Medical Centre in 2003 (before the establishment of an AAU) and 2006 (after the establishment of an AAU).

The study found that the mean length of hospital stay shortened from 6.8 days in 2003 to 5.7 days in 2006 – an increase in bed capacity of about 4391 bed-days per year – despite an increase of more than 50 per cent in the number of admissions, increased age of the patients, and an increase in the absolute number of patients with multiple co-morbidities.

“We face a steady increase in the number of acute medical admissions – any reduction in the length of hospital stay of general medical inpatients contributes significantly to the efficiency of care provision and availability of beds,” Dr Li said.

He said the study also found that the direct discharge rate within 24 hours increased from 13.2 per cent to 17.7 per cent after the establishment of an AAU.

The number of admitted patients waiting in the emergency department for a hospital bed for more than eight and 12 hours decreased, from 28.7 per cent to 17.9 per cent and 20.2 per cent to 10.4 per cent, respectively.

“The AAU provides early review of patients by a consultant physician and an appropriately skilled multidisciplinary treatment team of nurses and allied health staff. Our study suggests that senior and prompt input from consultants and an appropriately skilled multidisciplinary treatment team into each patient’s care facilitated the timely discharge of appropriate patients,” Dr Li said.

“It also facilitates appropriate treatment at the point of initial assessment and either transfer for ongoing care to the most appropriate specialty or early discharge.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

^{The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.}

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