The impact of the Ambulatory Care Unit (ACU) on ‘true admission avoidance’ at Basingstoke and North Hampshire Hospital

Abstract

The Ambulatory Care Unit (ACU) is a recent addition to Basingstoke and North Hampshire Hospital. In January 2017, additional acute medical consultants were appointed to help develop the service. The clinic is consultant led and operates Monday-Friday from 09.00-18.00. ACU accepts referrals directly from GPs and operates a push/pull system for the Emergency Department (ED). Out-of-hours referrals can be made via the medical registrar on call. Before expanding the service further, we studied the true impact of ACU by looking not only at patients diverted from the medical take, but also at 30-day readmission rates and mortality, thereby reflecting 'true' admission avoidance (TAA).

Economic evaluation of a medical ambulatory care service using a single group interrupted time‐series design

“…While results were mixed, Coffey et al 10 concluded that ambulatory care interventions ‘generally had a positive effect on most outcomes’. In addition, evaluations of two ambulatory care services in the United Kingdom, a GP‐referred unit 19 and a same‐day ambulatory emergency care service 20 reported reductions in 30‐day readmission rates and mortality. These programmes are similar to MACS in providing rapid service in subacute setting for GP‐referred and clinician‐referred patients.…”

“…GP GP-referred unit 19 and a same-day ambulatory emergency care service 20 reported reductions in 30-day readmission rates and mortality. These programmes are similar to MACS in providing rapid service in subacute setting for GP-referred and clinician-referred patients.…”

“…The medical ambulatory care service (MACS) is a South Australian hospital avoidance programme operating in southern Adelaide since 2016. Ambulatory care programmes provide out of hospital patient care, including diagnostic, treatment and rehabilitation services in postacute facilities 10,19,20 . MACS is currently operating as a dedicated medical unit located within the Noarlunga Hospital precinct, providing services predominantly to patients residing within the Southern Adelaide Local Health Network (SALHN) catchment area.…”

“…Ambulatory care programmes provide out of hospital patient care, including diagnostic, treatment and rehabilitation services in postacute facilities. 10,19,20 MACS is currently operating as a dedicated medical unit located within the Noarlunga Hospital precinct, providing services predominantly to patients residing within the Southern Adelaide Local Health Network (SALHN) catchment area. The principal purpose of MACS is to avoid presentations to SALHN-based ED and to decrease hospital admissions for patients with medical conditions that require urgent attention, but which could be safely treated in the ambulatory environment.…”