Timely treatment
New unit aims to improve emergency access and flow
Story by Amber Goulard; photo by Paul Rotzinger
 A new medical unit is being introduced within Alberta Health Services in an
effort to provide more timely treatment for patients waiting for hospital
admission.
Rockyview General Hospital in Calgary launched the province’s first medical
assessment unit in February as a demonstration initiative. The strategy is used
in other countries.
A second medical assessment unit is scheduled to open at the Royal Alexandra
Hospital in Edmonton in May.
The units act as a transition point between the emergency department and the
inpatient unit for patients awaiting hospital admission.
Now consultations, treatments and diagnostics can start in the medical
assessment unit, providing care to patients sooner while freeing beds in
emergency.
“We want to ensure patients are taken care of safely and that their inpatient
admission and treatment plan begins immediately instead of delayed by a lengthy
stay in the emergency department,” says Teresa Thurber, manager of Rockyview’s
12-bed medical assessment unit.
It has required Rockyview managers and staff to look at their processes and
determine how they can facilitate multiple admissions in a short time frame.
“The admission process can take upwards of an hour; by reviewing how we admit
patients, we’ve reduced that to half the time,” says Thurber.
“It’s a different way for medical inpatient nurses to do their work, so we
can admit patients quickly and facilitate flow.”
Amy Parnell, a nurse on the medical assessment unit, agrees the unit is fast
paced, compared with other medical inpatient units she’s worked on.
“It’s more focused; we learn what we need to know immediately with very
directed questions so the patient’s discharge process can be started
immediately,” she says.
“We streamline patients to where they need to go and, the minute we have a bed
open, we can offload from the emergency department in a big way.”
Typically, patients remain in a medical assessment unit for 24 to 48 hours.
“We can then move these patients to the most appropriate inpatient unit or
discharge them home,” says Kathy Schultz, director of medical services at
Rockyview.
Dr. Thomas Tam, the acute care division chief of family medicine in the Calgary
area, says medical assessment units and inpatient units share the same staffing
model and level of care.
The impact on the system, however, could be significant.
“Medical assessment units are designed to prevent gridlock by improving
patient flow and reducing wait times,” says Tam.
Beginning care earlier often leads to reduced length of stay – and this, too,
can have a dramatic impact across the system, says Dr. Grant Innes, clinical
department head of emergency medicine in the Calgary area.
“Even a four- or six-hour difference in hospital length of stay can save
hundreds of hospital beds every year for patients who really need them,” he
says.
Experiences at the Rockyview General Hospital and the Royal Alexandra
Hospital will be shared as medical assessment units are considered in more
hospitals across the province. | 