HEALTH: Two services successfully reduced A&E front door pressure

Dr Abigail Gunn receives her award at a ceremony in Inverclyde Royal Hospital.

By Lucy Ashton

Dr Abigail Gunn, Consultant in Acute and Stroke Medicine, and her team at Inverclyde Royal successfully implemented two safe and effective resources at the busy hospital to improve both patient care and patient flow.

The first service, was the Medical Assessment Unit (MAU). The MAU is a resource created next to Accident and Emergency (A&E) to enable both medical appointments and emergency walk-in patients to be promptly assessed by a medical team, including a nurse, advanced nurse practitioner, health care assistant, and middle grade doctor. Dr Gunn explained the significance of a resource like this in relation to improving patient experience;

“The MAU prevents patients from being admitted to the acute medical ward and subsequent delayed assessment, which can often lead to overnight admissions. Assessing patients at the MAU improves our patient centred care and, from a patient perspective, supports timely assessment and treatment.

“We have also been able to remove some of the pressure from the medical receiving units and downstream wards by facilitating OPAT (Outpatient Parental Antibiotic Treatment), post discharge reviews, blood transfusions and monitoring, outpatient follow up, assessment of GP referrals and much more,”

The MAU has been a proven success and has seen an average of 200 patients per month since its opening, with approximately 90% discharged. This has had a direct impact on improving the hospital’s overall patient flow.

In a similar vein, Dr Gunn and her team set up a trial for a Short Stay Unit (SSU) on the winter ward, also at Inverclyde Royal Hospital. The winter ward is part of the hospital’s seasonal plan to manage the increase of patients throughout colder months. The SSU was a four-bed unit with a twice-daily consultant input to facilitate monitoring and observations of patients with acute medical issues who required a short stay in the hospital. This unit was designed to enable 24-hour admission, assessment and discharging of patients.

Earlier this year, Dr Gunn was presented with the NHS Greater Glasgow and Clyde Excellence Award 2023 for Better Care for the establishment of these two resources. She was also recognised for continuing her usual workplace requirements while establishing these resources and being a focal point for the junior doctors, advance nurse practitioners, and trainees rotating through the hospital, arranging inductions for these doctors, and providing support, advice and supervision as required.

“Working at the forefront of these two projects and witnessing them growing into successful services has been incredibly rewarding. Watching the team adapt and contribute to achieve that success has also been incredible and I’m grateful for their support. I’m delighted to have been recognised at the Excellence Awards for this work and am looking forward to what we’ll achieve as our work continues,” said Dr Gunn.

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