• Anne Marie O'Flynn, Ceara Hart, Adelina Munoz-Claros, Daniel Schmidt, John Kiely, Conor Deasy, and Cathal O'Donnell.
• Department of Medicine, Mallow General Hospital, Mallow, Co Cork, P51 N288, Ireland. annemarie.oflynn@hse.ie.
• Ir J Med Sci. 2024 Feb 1; 193 (1): 383-8.

BackgroundReconfiguration of the Irish acute hospital sector resulted in the establishment of a Medical Assessment Unit (MAU) in Mallow General Hospital (MGH). We developed a protocol whereby certain patients deemed to be low risk for clinical deterioration could be brought by the National Ambulance Service (NAS) to the MAU following a 999 or 112 call.AimsThe aim of this paper is to report on the initial experience of this quality improvement initiative.MethodsThe Plan-Do-Study-Act (PDSA) Cycle for quality improvement was implemented when undertaking this project. A pathway was established whereby, following discussion between paramedic and physician, patients for whom a 999 or 112 call had been made could be brought directly to the MAU in MGH. Strict inclusion and exclusion criteria were agreed. The protocol was implemented from the 1st of September 2022 for a 3-month pilot period.ResultsOf 39 patients discussed, 29 were accepted for review in the MAU. One of the 29 accepted patients declined transfer to MAU. Of 28 patients reviewed in the MAU, 7 were discharged home. One patient required same day transfer to a model 4 centre. Twenty patients were admitted to MGH with an average length of stay of 8 days. Frailty and falls accounted for 7 of the admissions and the mean length of stay for these patients was 12 days.ConclusionsOur results have demonstrated the safety, feasibility and effectiveness of this pathway. With increased resourcing, upscaling of this initiative is possible and should be considered.© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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