Reorganizing a hospital ward as an accountable care unit.
Traditional hospital wards are not specifically designed as effective clinical microsystems. The feasibility and sustainability of doing so are unclear, as are the possible outcomes. To reorganize a traditional hospital ward with the traits of an effective clinical microsystem, we designed it to have 4 specific features: (1) unit-based teams, (2) structured interdisciplinary bedside rounds, (3) unit-level performance reporting, and (4) unit-level nurse and physician coleadership. We called this type of unit an accountable care unit (ACU). In this narrative article, we describe our experience implementing each feature of the ACU. Our aim was to introduce a progressive approach to hospital care and training.
Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia.
Jason
J
Stein
Christina
C
Payne
Amanda
A
Methvin
Joanna M
JM
Bonsall
Liam
L
Chadwick
Diaz
D
Clark
Bryan W
BW
Castle
David
D
Tong
Daniel D
DD
Dressler
D060866:Accountable Care Organizations / Q000379:methods* / Q000458:organization & administration*; D005260:Female; D006748:Hospital Departments / Q000379:methods* / Q000458:organization & administration*; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D010820:Physicians / Q000458:organization & administration*