title: Acute medical assessment units: an efficient alternative to in-hospital acute medical care.
abstract: Acute Medical Assessment Units (AMAUs) are being proposed as an alternative to congested Emergency Departments (EDs for the assessment of patients with a range of acute medical problems. We retrospectively reviewed the discharge destination of patients referred to a newly established AMAU during a six-month period. During the same period we contrasted activity in the ED for a similar group of patients. 1,562 patients were assessed in the AMAU. 196 (12.5%) were admitted to an in-patient bed and 1,148 (73.5%) were entered into specific diagnosis-driven out-patient pathways. 1,465 patients attended the ED and 635 (43.3%) were admitted. Out-patient alternatives to expensive in-patient care need to be provided at the 'coal face" of acute referral. The AMAU provides this, and as a consequence admission rates are relatively low. This is achieved by directly communicating with GPs, accessing senior clinical decision makers, and providing immediate access to diagnostically driven outpatient pathways.
authors.affiliation: Department of Medicine, Mid-Western Regional Hospital, Dooradoyle, Limerick. michael.watts@hse.ie
authors.forename: M
authors.initials: M
authors.lastname: Watts
authors.forename: L
authors.initials: L
authors.lastname: Powys
authors.forename: C O
authors.initials: CO
authors.lastname: Hora
authors.forename: S
authors.initials: S
authors.lastname: Kinsella
authors.forename: J
authors.initials: J
authors.lastname: Saunders
authors.forename: L
authors.initials: L
authors.lastname: Reid
authors.forename: P
authors.initials: P
authors.lastname: Finucane
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007494:Ireland; D017146:Models, Organizational; D014218:Triage / Q000458:organization & administration