An increase in daily patient slots in the Medical Assessment Unit (MAU) at Ennis Hospital is enabling GPs to refer up to an additional 56 patients every week and further reduce pressure on the Emergency Department (ED) at University Hospital Limerick (UHL).
The Medical Assessment Unit at Ennis Hospital has since 2016 run as a seven-day service (8am-8pm Monday to Friday, and 10am-6pm Saturday and Sunday), with 16 patient slots Monday to Friday and 10 slots on Saturday and Sunday. In early January, this was expanded by eight slots daily, allowing for the assessment of another 56 patients every week.
Funding for the service improvement was provided by the National Treatment Purchase Fund, allowing for the appointment of a nurse, a cardiac technician, a doctor, clerical and facilities support to create the additional daily assessment slots at the unit.
MAUs provide assessment, diagnosis and treatment for patients referred with medical conditions including chest infections, COPD (chronic obstructive pulmonary disease), pneumonia, urinary tract infections, fainting episodes, clots in the leg, anaemia or non-acute cardiac problems.
GPs—or the ED—will initially assess and refer patients to MAUs for appointment the same day or following day. The multidisciplinary team at Ennis MAU led by consultant physician Dr Tom Peirce, works towards same-day diagnosis, treatment and discharge, and see all patients within an hour of arrival.
Approximately 10% of cases may require admission to the hospital, and the majority will be discharged, with a follow-up review in the unit within 48 hours.
Even prior to the early 2020 service improvement, Ennis MAU was demonstrably fulfilling a key role in UL Hospitals Group efforts to facilitate alternative care pathways to the busy Emergency Department (ED) at University Hospital Limerick.
During 2019, there was a 4.2% increase in patient referrals to Ennis MAU on the 4,542 patients referred the previous year. The rate of increase was precisely in line with the collective referrals across all four of the Group’s MAUs (the others being located at UHL, Nenagh and St John’s). During the same period, attendances at the ED in UHL fell by 507, a decrease of 0.7% on ED presentations the previous year.
Patricia O’Gorman, Operational Director Of Nursing at Ennis Hospital, explains that the service improvement creates greater flexibility for GPs and their patients: “The assessment slots will be open later in the afternoon, providing GPs with more opportunities to get same-day or next-day medical assessment and treatment for patients they deem suitable for the service.”
“Significant numbers of patients attend the ED at UHL for a medical assessment. Patients from Clare can save travel time and wait times by being referred to the MAU in Ennis by their GP. In the MAUs, suitable patients have better access to efficient and effective treatment, with good patient experience times,” she adds.
The MAU team and Ennis Hospital will continue to work closely with their GP colleagues in County Clare and throughout the region, who regard the model of care as particularly suitable for elderly people and patients suffering from chronic conditions, who will be seen and treated more quickly than they would in a busy ED.
“Patient and GP feedback confirms that the MAU is positively impacting on healthcare in this region, and having a tangible effect on reducing attendances at the ED. The additional patient slots will help to make an already efficient service even more accessible and effective,” Patricia O’Gorman concludes.
The MAU in Ennis Hospital opens from 8am-8pm Monday to Friday, and 10am-6pm Saturday and Sunday. The MAUs in UHL, Nenagh and St John’s are open 8am-6pm Monday to Friday.
MAUs should not be confused with Injury Units or Local Injury Units which are for the treatment of minor injuries in patients aged 5 years and older, and to which patients can self-refer or be referred by their GP.