Work

323 A service evaluation of a new initiative; the Mercers Acute Medical Assessment Unit for Older Adults (MASU)

Year: 2023

Type: article

Abstract: Background Mercers Acute Medical Assessment Unit for Older Adults (MASU), a new service, was developed to expedite diagnosis, reduce delays in treatment and avoid unnecessary admissions in older adults presenting to hospital. Methods This was a retrospective review of the MASU service which included a dedicated registrar and consultant geriatrician assessing adults > = 70 years with geriatric needs in the emergency department. Adults reviewed by the MASU team over a 16-week period (June 20th–Oct 9th 2022) were reviewed. MASU operated between 9.00–17.00 (Monday–Thursday) and 9.00–16.00 (Friday). The usual on-call service operated outside these hours. Results Over 16-weeks, 348 patients were admitted; 166 (47.7%) by MASU, 182 (52.3%) by out of hours (OOH). Patients’ average age was 83.1 years, 57.8% were female and median length of stay was 11 days (9.3 MASU vs 14.4 OOH). Twenty-four hour discharge rates were 13.2% for MASU vs 3.7% for OOH, 48-hour discharge rates were 18% MASU vs 9.8% OOH and 72-hour discharge rates 23.4% MASU vs 17.7% OOH. Four-week data for (July 2022) were compared to the same 4-week period in 2019; Day time admissions were higher in 2022 (70% vs 50.3%). Of those admitted by MASU, 14.3% were accepted directly from triage avoiding ED review and delays in specialist input. Despite admissions in 2022 being on average 3.6 years older (85.7 years vs 82.1 years) and frailer (85.7% > =5CFS vs 54% > =5CFS), more were discharged ≤24 hours after presentation (14.3% vs 8.1%) with 30-day readmission rates (26.2% vs 29.7%) and 30-day mortality (7.1% vs 8.1%) remaining static. Conclusion Having a dedicated consultant geriatrician and registrar allocated to review older adults with geriatric needs attending the emergency department lead to earlier discharges, thus potentially avoiding hospital associated morbidity.

Source: Age and Ageing

DOI: 10.1093/ageing/afad156.301