Medical assessment units should be set up in each acute general hospital in the State, a Comhairle na nOspideál report has recommended. Dr Muiris Houston, Medical Correspondent, reports.
The report, published yesterday, said such units have been shown to substantially reduce the time spent waiting for admission to hospital.
Comhairle, the statutory body responsible for consultant appointments in the Republic, came out strongly in favour of the units, which have already proven their worth in hospitals such as St Luke's, Kilkenny. However, it has suggested the units be renamed Acute Medical Units (AMUs).
The Minister for Health, Ms Harney, was presented with a copy of the report by Dr Cillian Twomey, chairman of Comhairle na nOspideál, yesterday. In a clear indication that AMUs will form part of her strategy to deal with the accident and emergency crisis, Ms Harney said: "It is an excellent report and it certainly will inform my thinking and my decisions in the context of the estimates".
Among the report's recommendations are that patients in AMUs be given "fast track access" to a full range of diagnostic services and that hospital consultants carry out ward rounds at least twice daily in an AMU. "This will ensure that patients requiring transfer to a speciality bed or discharge home are identified on a regular basis throughout the day," it states.
The report said AMUs should provide services to two broad categories of patients: those who are acutely medically ill and need immediate assessment and treatment and patients with medical problems where clinical uncertainty exists.
The committee observed from the consultation process that the medical units which had the greatest positive impact on patients and their wellbeing were those that had the dedicated on-site services of allied health professionals (occupational therapists and physiotherapists).
It recommended that each AMU operate under clear protocols and guidelines for access and discharge. For those units focusing solely on medical assessment, the report recommends that a patient not stay longer than 8-12 hours. However, for AMUs with an admission function, "the maximum length of stay is likely to be from three to five days". It also says that patients requiring admission from the AMU should be given priority access to beds in the hospital.
Commenting on the bed capacity issues associated with AMUs, Comhairle na nOspideál said it may be possible to redesignate existing beds in some hospitals, while additional beds will be required in others.
Dr Twomey said the report was timely "in that it provides a partial solution to the perennial accident and emergency problem".