Evaluation of the impact of implementation of a Medical Assessment and Planning Unit on length of stay.
OBJECTIVE
The Medical Assessment and Planning Unit (MAPU) model provides a multidisciplinary and 'front end loading' approach to acute medical care. The objective of this study was to evaluate the impact of a 10-bed MAPU in Royal Melbourne Hospital (RMH) on hospital length of stay.


METHODS
A pre-post study design was used. Cases were defined as all general medical patients admitted to the RMH between 1 August 2003 and 31 January 2004. MAPU patients were defined as general medical patients who had been discharged from RMH MAPU unit as part of their RMH inpatient admission. Historical controls were defined as all general medical patients admitted to the RMH between 1 August 2002 and 31 January 2003.


RESULTS
There was a reduction in median length of stay that did not reach statistical significance. During the study period, median emergency department length of stay for MAPU patients was 10.3 h compared with 13.2 h for non-MAPU patients who were admitted directly to general wards.


CONCLUSIONS
The reductions in length of stay are likely to be of clinical significance at the emergency department (ED) level. The MAPU model also contributes to providing care appropriate care for older admitted patients.
Brand
Caroline A
CA
Centre for Research Excellence in Patient Safety (CREPS), Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia. caroline.brand@mh.org.au
Kennedy
Marcus P
MP
King-Kallimanis
Bellinda L
BL
Williams
Ged
G
Bain
Christopher A
CA
Russell
David M
DM
D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D019982:Organizational Case Studies; D015397:Program Evaluation; D014218:Triage / Q000458:organization & administration*; D014739:Victoria