Acute medical unit: experience from a tertiary healthcare institution in Singapore

Singapore's healthcare system is under strain from the rising demands of an increasing and ageing population, resulting in delayed specialist care for patients presenting to the emergency department and requiring admission. Acute assessment units have been developed elsewhere but are not well established in local healthcare. Our institution extended our acute medical team to form an acute medical unit (AMU), in which focused internist-led teams are stationed on site to rapidly assess and re-triage patients. All patients (excluding those with very complex conditions) are admitted to the AMU and managed by internists who provide holistic, patient-centric care with better ownership, improved efficiency and less fragmentation. Patients can receive timely access to medical interventions and stable patients can benefit from early supported discharge, anchored by the nursing, allied health and transitional care teams. Given the ageing patient population with multiple comorbidities, this integrated model with exceptional outcomes is highly suitable for Singapore.