New unit to assess patients

Editorial Department Sarah Saunderson - 1503 • Published 6 Aug 2009 09:00 0 Comments

See also:

A new assessment unit has been set up at the Erne Hospital designed to care for the majority of acute admissions to the hospital.

The Medical and Surgical Assessment Unit (MASAU) has been operating for just over five weeks. In the first month of opening, 539 patients, approximately 16 patients per day, were admitted to the MASAU, with 81 per cent staying less than 24 hours. Of these patients admitted to the unit, 51 per cent were transferred to a ward and 49 per cent were discharged home.

Lead Clinician, Dr. Breffni Keegan, explained: "We are hoping that most acute admissions to the Erne Hospital will travel through here. These are the illest patients and we are geared for them to get to assessment and investigations rapidly and re-evaluation of that information to be decided on rapidly.

"In days gone by in hospital, acute patients could be found dotted amongst many wards. Here, they are concentrated in one place with all the members of the team working towards treating acutely ill patients and geared towards that. If they need treatment at High-Dependency or Intensive Care, it is just a few steps away. We have very good relations with our colleagues there.

"On the investigation side we can get most x-rays investigations that day, within reason. As soon as people are assessed, they are not waiting round to have this done," he said.

The provision of such a rapid assessment unit fits with the model of care planned for the new South West Hospital, which is due to open in 2012. It is also a type of care recommended by the Royal College of Physicians and Surgeons and now has been implemented here by the Western Health and Social Care Trust, which manages the hospital.

"It is a more modern way of doing things. It gets the right person to the right place at the right time. It is getting the patients to an area designed for assessing them and giving them rapid, appropriate treatment. If they require staying on at the unit or moving on to other wards, we expedite it as quickly as possible," Dr. Keegan said.

Temporary Ward Sister Ruth Beaumont said: "It is about providing a better patient experience; that they are being seen and being treated. Doctors and nurses are geared up towards acute admissions. The feedback to date has been very positive," she said.

The new unit has the capacity for 16 patients. It receives all medical and surgical patients referred by GPs, to assess the need for admission to hospital. The unit also receives urgent adult medical and surgical patients requiring further assessment and or treatment from other areas such as A&E, outpatients and the mobile coronary care unit.

Located on the first floor where Gynae ward used to be, the unit looks after both male and female patients. "As much as we can, we try to keep the bays separate," said Dr. Keegan.

The 24-hour unit has a staff of 20 nurses, with four nurses working on a shift together with two nursing auxilliaries. Headed by temporary Ward Sister Beaumont, she is on secondment from the Surgical Ward. Sister Beaumont qualified in 1990, working at the Erne, before working for 14 years in Oxford. She returned to work at the Erne three years ago, where she has been working in Theatre prior her move to her present post three months ago.

The medical staff are headed by Dr. Keegan, who like Sr. Beaumont, also returned to work in the Erne after an initial period working in Enniskillen in the earlier part of his career.

He qualified in Dublin and began his general doctor post in the Erne. After two years he moved on to Belfast. He also worked in Scotland before finishing training in East Anglia. As a consultant, he worked in Norfolk before moving back to Fermanagh 19 months ago as his wife has local ties with the area.

All patients admitted to the MASAU will initially be assessed by the relevant staff grade/senior doctor. On examining the patient, the doctor will decide whether further examinations, such as x-rays or scans, will be required. The doctor will make a decision to either admit the patient to a ward, advise them to remain in the unit for further observation or discharge them to the care of their GP. Direct discharge to residential or nursing home care will also be made, if appropriate, as will referrals to intermediate care teams including Rapid Response Nursing.

The unit is designed for short stays of patients and the maximum stay will be 24 to 48 hours.

Patients who are not suitable for the MASAU are 999 collapse calls, self-referred patients, patients arriving by blue flashing ambulance and

patients solely with mental health problems

Other admissions will continue in the normal way.

These are:

• Direct non-acute admission for patients over the age of 65 years to the Medical Rehabilitation Unit for the elderly, in consultation with one of the consultant geriatricians.

• Direct acute stroke admissions to the Stroke Unit (Ward 9).

• Direct elective planned admission to general medicine as arranged by consultants or staff grade doctors.

• Direct elective planned admission to general surgery as arranged by consultants or staff grade doctors.

• Planned medical/ surgical outpatient admission arranged.

• Transfer out of the HDU/ ICU unit through direct liaison between senior nursing staff.

• Emergency patients assessed by appropriate medical/surgical staff in the A&E department.

This article appeared in Impartial Reporter 06 Aug 09

Return to the main index, get more from this section or browse our News archives.