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Intermediate care model in the Medical Surveillance Unit

29-Feb-2016

On January 15, 2016 MSU launched an intermediate care model within the Pasqua Hospital and to date we have admitted and cared for 62 patients who have met the MSU specific criteria. We have also assisted patient flow by caring for 10 patients who would have otherwise been overcapacity.

We have created a robust dashboard for data collection that has been designed to provide us with real time information for analysis and evaluation. Currently, 50% of our patient volume has been from the Emergency Department, 22% through Intensive Care transfers and 28% has been from other inpatient medical areas including post-operative patients who require a higher level of care or monitoring.

We are continuously looking to enhance our delivery of service. Using our dashboard data, feedback from our partners and patients, we are continuously implementing change.We will closely follow the workload and acuity; admissions and patient flow of this new unit over the next six months.

All patients are admitted to the Hospitalist and all are consulted to General Internal Medicine. Using the same model as the Accountable Care Unit, Structured Interdisciplinary Bedside Rounds (SIBR) and shift to shift nursing report handover at the bedside have been implemented. Library staff is available weekly to assist with answering complex patient, nursing and physician questions.

Assessing real time patient condition using the newly adoptedEarly Assessment Response System (EARS) has been very useful in allowing staff to not only intervene in a timely fashion to changes in the status of patient vital signs, but to quantify patient acuity and manage the requirements of appropriate staffing models related to patient needs.

In this time of high inpatient capacity, we have worked with Patient Flow and the ACU to have mechanisms that ensure that patients can be rapidly streamlined from the ER to the wards.

Overall, there are multiple concurrent initiatives aimed at providing high level, safe, evidence based care.