Restoring the core acute medical unit (AMU) function – a quality improvement initiative from a district general hospital

The acute medical unit (AMU) is a specialist area, focused on delivering timely, effective acute care for adults with acute medical illness. AMUs were first established to provide timely physician review, risk stratification and multidisciplinary management in the first 72 h. They are designed to improve patient care, prevent unnecessary admissions and reduce morbidity and mortality. However, national benchmarking and local audit data showed that core acute medicine processes at Frimley Park Hospital's AMU had drifted from these standards. A structured quality improvement programme was therefore implemented to restore AMU function and align operational processes and workforce to national guidance and national Getting it Right First Time (GIRFT) principles. Real-time oversight, standardised multidisciplinary team board rounds and rota alignment to peak demand, halved AMU length of stay, doubled daily discharges and increased emergency department-to-AMU transfers. These improvements were associated with enhanced hospital-wide throughput and more effective early acute care.