Acute Medicine Specialist Registrar, Norfolk and Norwich University Hospital, Norwich, UK.
Intern Med J. 2011 Jan;41(1a):19-26. doi: 10.1111/j.1445-5994.2010.02359.x.
To ascertain the design and operational characteristics of acute Medical Assessment Units (MAU) located within Australasian hospitals, and to compare these with formal standards promulgated by the Internal Medicine Society of Australia and New Zealand (IMSANZ).
Descriptive study based on responses to questionnaires mailed to clinical and nursing leads of MAU in March 2009 with follow-up reminders over 3months. Hospitals that had an MAU that met predefined criteria were identified from an IMSANZ directory of sites based on recent contact with IMSANZ members and health department personnel and interrogation of hospital websites and attendance lists at recent MAU workshops.
Questionnaires were returned from 32 of 50 hospitals (response rate 64%). Most MAU (15/22; 68%) were less than 2years old. MAU were smaller than recommended by IMSANZ. Sixty-eight per cent were located over a 5-min walk from the emergency department (ED). Delay in transfer of patients from the ED to the MAU was common. The medical service to the majority of MAU was provided by General Medicine physicians and cover was reduced at weekends. In the majority of MAU the emphasis on function was facilitating discharge of patients rather than managing patients with high acuity of illness.
Our survey suggests that despite some variation in staffing and procedures, MAU seem to be well established and a promising means of decreasing ED access block. Future comparative study is required to evaluate further the effect of MAU on ED access block and ED length of stay.
确定位于澳大拉西亚医院内的急性医疗评估单元（MAU）的设计和运行特点，并将其与澳大利亚和新西兰内科医师学会（IMSANZ）颁布的正式标准进行比较。
基于对 2009 年 3 月邮寄给 MAU 临床和护理负责人的问卷的描述性研究，并在 3 个月内进行了后续提醒。根据最近与 IMSANZ 成员和卫生部门人员的联系以及对医院网站和最近 MAU 研讨会出席名单的查询，从 IMSANZ 网站目录中确定了符合预设标准的 MAU 所在的医院。
从 50 家医院中返回了 32 份问卷（回应率为 64%）。大多数 MAU（22 个中的 15 个；68%）的历史不到 2 年。MAU 比 IMSANZ 建议的要小。68%的 MAU 距离急诊部（ED）步行不到 5 分钟。将患者从 ED 转移到 MAU 的延迟很常见。大多数 MAU 的医疗服务由内科医师提供，周末的覆盖范围会减少。在大多数 MAU 中，功能重点是促进患者出院，而不是管理病情严重的患者。
我们的调查表明，尽管在人员配备和程序方面存在一些差异，但 MAU 似乎已经建立得很好，是减少 ED 通道阻塞的一种有前途的方法。未来需要进行进一步的比较研究，以评估 MAU 对 ED 通道阻塞和 ED 住院时间的影响。
