Basildon EM Handbook 2018

Medical Ambulatory Emergency Care Unit

March 2018 | by EMauthor

The numbers of emergency attendances and of patients who are subsequently admitted to hospital are rising, putting pressure on the emergency departments. Ambulatory Emergency Care is an emerging, streamlined way of managing patients presenting to hospital who would traditionally be admitted. Instead, they can be treated in an ambulatory care setting and discharged the same day – offering benefits to patients, carers, support workers and the Trust.

MAECC selection methods;

•Passive – patients are referred to MAEC from ED (including triage)

oIn hours phone the MAEC DECT phone and refer as with any other specialty. There are many helpful pathways on the Hub however the patient does not have to meet these pathways if you feel they would be suitable

oOut-of-hours fill in a form located in the MAEC box in majors and leave a photocopy of the patient notes. Must be approved by a senior and remember you are still responsible for the discharge. Give the patient a leaflet which should be in the box.

•Pull – clinical staff working in AMU identify patients for MAEC

Common pitfalls with out-of-hours referrals

•Do not give the patient a date and time to come to MAEC unless you are asked to by the accepting clinician. The patients will be contacted by the unit within 36 hours.

•Ensure patient contact details are up-to-date on the front sheet and referral card

•Never use the unit as a safety-net clinic ( i.e. only to ensure a patient is getting better).  Safety netting is part of a safe ED discharge.

•Do not 'promise' the patient specific investigations

•Do not ambulate a patient with a suspected PE out-of-hours. These should be admitted under the medical team.

•Do not send a patient home for a ROACS repeat troponin in the morning.

•Do not refer patients with a suspected DVT (unless this is for a specific reason) as there is a separate pathway for this.

•Do not admit patients to CDU to go to ambulatory care in the morning: such patients should be admitted under the medical team.

Links

•HOSPITAL ADMISSION

•HOME

•INTRANET HUB