Enhanced Care Units: Guidance on development and implementation within Acute Medicine

Area of Science:

• Medical Specialties
• Healthcare Management

Background:

• Acute Medicine Units (AMU) often manage complex patients requiring higher levels of monitoring.
• Existing care models may not fully address the needs of acutely unwell patients requiring enhanced observation and support.
• Collaboration between Acute Medicine and Intensive Care is crucial for optimizing patient outcomes.

Purpose of the Study:

• To provide joint guidance on standards for enhanced care within Acute Medicine.
• To define the necessary infrastructure and care delivery models for enhanced care units.
• To clarify the role of enhanced care as a complement to critical care.

Main Methods:

• Development of joint guidance by the Society for Acute Medicine (SAM) and Intensive Care Society (ICS).
• Incorporation of expertise and existing guidance from relevant professional bodies including the Faculty of Intensive Care Medicine (FICM), British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE), and NHS England / Improvement (NHSE/I).
• Acknowledgement of the limited evidence base and commitment to regular review.

Main Results:

• Establishment of standards for enhanced care units within Acute Medicine.
• Emphasis on co-location, enhanced monitoring, and increased nursing input for patient safety and quality.
• Clear delineation that enhanced care units are not a substitute for critical care.

Conclusions:

• Enhanced care units are a valuable addition to Acute Medicine, improving care for specific patient cohorts.
• Close working relationships between Acute Medicine and Intensive Care are essential for modern acute care delivery.
• The guidance will be regularly reviewed to incorporate evolving evidence and experience.