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Acute medical units, providing continuity of care may be the next focus
European Journal of Internal Medicine 39 (2017) e12
Contents lists available at ScienceDirect
European Journal of Internal Medicine journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor Acute medical units, providing continuity of care may be the next focus Keywords: Acute Medical Units Acute medicine Models of acute care
Dear Sir, With great interest I have read the manuscript by van Galen et al. [1] about the organization and benefits of Acute Medical Units (AMUs). In our university medical centre, we started the AMU in 2008. Its organization differs from most AMUs van Galen et al. described, and hereby we would like to add a few recommendations based on our experience. We have a 20 bed ward, to which 3300 patients of all specialties are admitted yearly. Our policy is to admit only those patients who can be discharged home within 72 h and who do not need medium or intensive care. The advantage of the 72 hour criterion is that the majority of patients do not have to be transferred to other departments. Transfers are not pleasant for patients, and may lead to loss of efficiency and decreased patient safety because of loss of information. In our hospital, 81% of AMU patients are indeed discharged home and the mean length of stay is 2 days. Another characteristic of the organization of our AMU is continuity of care. The internist who admits the patient from the emergency
department is – most of the time (between 8 am and pm) - the one who has accepted the patient for assessment at the ED after consultation with the general practitioner, and is the one who takes care of the same patient during stay in the AMU. After discharge, the same (team of) internist(s) takes care of the patient, when he returns to the outpatient clinics. This continuity in care is efficient and decreases the chance of losing information. In conclusion, the aim to admit only those patients who can be discharged home within 72 h and the focus on continuity of care may be two ways to improve the efficiency and quality of the acute care chain, and the AMU in particular. Reference [1] van Galen LS, et al. Acute medical units: the way to go? A literature review. Eur J Intern Med 2017;59:24–31.
Patricia M Stassen Maastricht University Medical Centre, Department of Internal Medicine, Division of General Medicine, Section Acute Medicine, The Netherlands
DOI of original article: http://dx.doi.org/10.1016/j.ejim.2016.11.001.
http://dx.doi.org/10.1016/j.ejim.2017.01.005 0953-6205/© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
3 January 2017
Contents lists available at ScienceDirect
European Journal of Internal Medicine journal homepage: www.elsevier.com/locate/ejim
Letter to the Editor Acute medical units, providing continuity of care may be the next focus Keywords: Acute Medical Units Acute medicine Models of acute care
Dear Sir, With great interest I have read the manuscript by van Galen et al. [1] about the organization and benefits of Acute Medical Units (AMUs). In our university medical centre, we started the AMU in 2008. Its organization differs from most AMUs van Galen et al. described, and hereby we would like to add a few recommendations based on our experience. We have a 20 bed ward, to which 3300 patients of all specialties are admitted yearly. Our policy is to admit only those patients who can be discharged home within 72 h and who do not need medium or intensive care. The advantage of the 72 hour criterion is that the majority of patients do not have to be transferred to other departments. Transfers are not pleasant for patients, and may lead to loss of efficiency and decreased patient safety because of loss of information. In our hospital, 81% of AMU patients are indeed discharged home and the mean length of stay is 2 days. Another characteristic of the organization of our AMU is continuity of care. The internist who admits the patient from the emergency
department is – most of the time (between 8 am and pm) - the one who has accepted the patient for assessment at the ED after consultation with the general practitioner, and is the one who takes care of the same patient during stay in the AMU. After discharge, the same (team of) internist(s) takes care of the patient, when he returns to the outpatient clinics. This continuity in care is efficient and decreases the chance of losing information. In conclusion, the aim to admit only those patients who can be discharged home within 72 h and the focus on continuity of care may be two ways to improve the efficiency and quality of the acute care chain, and the AMU in particular. Reference [1] van Galen LS, et al. Acute medical units: the way to go? A literature review. Eur J Intern Med 2017;59:24–31.
Patricia M Stassen Maastricht University Medical Centre, Department of Internal Medicine, Division of General Medicine, Section Acute Medicine, The Netherlands
DOI of original article: http://dx.doi.org/10.1016/j.ejim.2016.11.001.
http://dx.doi.org/10.1016/j.ejim.2017.01.005 0953-6205/© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
3 January 2017