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The acute medical unit model: A characterisation based upon the National Health Service in Scotland

BACKGROUND: Acute medical units (AMUs) receive the majority of acute medical patients presenting to hospital as an emergency in the United Kingdom (UK) and in other international settings. They have emerged as a result of local service innovation in the context of a limited evidence base. As such, t...

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Autores principales: Reid, Lindsay E. M., Pretsch, Ursula, Jones, Michael C., Lone, Nazir I., Weir, Christopher J., Morrison, Zoe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169877/
https://www.ncbi.nlm.nih.gov/pubmed/30281643
http://dx.doi.org/10.1371/journal.pone.0204010
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author Reid, Lindsay E. M.
Pretsch, Ursula
Jones, Michael C.
Lone, Nazir I.
Weir, Christopher J.
Morrison, Zoe
author_facet Reid, Lindsay E. M.
Pretsch, Ursula
Jones, Michael C.
Lone, Nazir I.
Weir, Christopher J.
Morrison, Zoe
author_sort Reid, Lindsay E. M.
collection PubMed
description BACKGROUND: Acute medical units (AMUs) receive the majority of acute medical patients presenting to hospital as an emergency in the United Kingdom (UK) and in other international settings. They have emerged as a result of local service innovation in the context of a limited evidence base. As such, the AMU model is not well characterised in terms of its boundaries, patient populations and components of care. This makes service optimisation and development through strategic resource planning, quality improvement and research challenging. AIM: This study aims to evaluate a national set of AMUs with the intent of characterising the AMU model. METHODS: Twenty-nine AMUs in Scotland were identified. Data were collected by semi-structured interviews with multidisciplinary healthcare professionals working in each AMU. A draft report was produced for each unit and verified by a unit representative. The unit reports were then analysed to develop a conceptual framework of key components of AMUs and a service definition of the boundaries of acute medical care. RESULTS: Acute medical care in Scotland can be described as being delivered in “acute medical services” rather than geographically distinct AMUs. Twelve key components of AMU care were identified: care areas, functions, populations, patient flow, support services, communication, nurse care, allied healthcare professional care, non-consultant medical care, consultant care, patient assessment and specialty care. DISCUSSION: This empirically derived characterisation of the AMU model is likely to be of utility to practitioners, managers, policy makers and researchers: it is relevant on an operational level, will aid quality improvement and is a foundation to needed further research into how best to deliver care in AMUs. This is important given the central role AMUs play in the journey of the majority of patients presenting to hospital acutely in Scotland, the UK and internationally.
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spelling pubmed-61698772018-10-19 The acute medical unit model: A characterisation based upon the National Health Service in Scotland Reid, Lindsay E. M. Pretsch, Ursula Jones, Michael C. Lone, Nazir I. Weir, Christopher J. Morrison, Zoe PLoS One Research Article BACKGROUND: Acute medical units (AMUs) receive the majority of acute medical patients presenting to hospital as an emergency in the United Kingdom (UK) and in other international settings. They have emerged as a result of local service innovation in the context of a limited evidence base. As such, the AMU model is not well characterised in terms of its boundaries, patient populations and components of care. This makes service optimisation and development through strategic resource planning, quality improvement and research challenging. AIM: This study aims to evaluate a national set of AMUs with the intent of characterising the AMU model. METHODS: Twenty-nine AMUs in Scotland were identified. Data were collected by semi-structured interviews with multidisciplinary healthcare professionals working in each AMU. A draft report was produced for each unit and verified by a unit representative. The unit reports were then analysed to develop a conceptual framework of key components of AMUs and a service definition of the boundaries of acute medical care. RESULTS: Acute medical care in Scotland can be described as being delivered in “acute medical services” rather than geographically distinct AMUs. Twelve key components of AMU care were identified: care areas, functions, populations, patient flow, support services, communication, nurse care, allied healthcare professional care, non-consultant medical care, consultant care, patient assessment and specialty care. DISCUSSION: This empirically derived characterisation of the AMU model is likely to be of utility to practitioners, managers, policy makers and researchers: it is relevant on an operational level, will aid quality improvement and is a foundation to needed further research into how best to deliver care in AMUs. This is important given the central role AMUs play in the journey of the majority of patients presenting to hospital acutely in Scotland, the UK and internationally. Public Library of Science 2018-10-03 /pmc/articles/PMC6169877/ /pubmed/30281643 http://dx.doi.org/10.1371/journal.pone.0204010 Text en © 2018 Reid et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Reid, Lindsay E. M.
Pretsch, Ursula
Jones, Michael C.
Lone, Nazir I.
Weir, Christopher J.
Morrison, Zoe
The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title_full The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title_fullStr The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title_full_unstemmed The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title_short The acute medical unit model: A characterisation based upon the National Health Service in Scotland
title_sort acute medical unit model: a characterisation based upon the national health service in scotland
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169877/
https://www.ncbi.nlm.nih.gov/pubmed/30281643
http://dx.doi.org/10.1371/journal.pone.0204010
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