Key messages

  • Observation medicine units provide alternative medical spaces for short-stay emergency (ED) patients.
  • Observation units can help reduce patient length of stay, fast track care and enhance the patient experience.
  • Guidelines assist hospital EDs to establish and run observation medicine units.

Observation medicine delivers intensive short-term assessment, observation or therapy to optimise the early treatment and discharge of selected patients.

There are two types of observation medicine units:

  • short stay observation units
  • medical assessment and planning units.

Short stay observation units

Short stay observation units (SOU) are emergency department-based models designed for patients who, with proper assessment and treatment, are likely to be discharged within 24 hours.

This includes patients who require tests to determine the seriousness of their emergency condition (for example, minor head injury, chest pain or drug overdose). It also includes patients who require a short course of treatment for conditions that can be resolved quickly (for example, asthma, allergic reactions or renal colic).

Emergency department physicians manage these patients whose expected length of stay is four to 24 hours.

Short stay observation units also provide a location for patients to receive allied health and social support intervention, such as physiotherapy assessment or social welfare services before discharge.

Medical assessment and planning units

Medical assessment and planning units (MAPU) are designed to care for medical inpatients who require observation, care and treatment prior to transfer to an appropriate ward, or discharge.

Generally, MAPU patients are managed by medical physicians with collaborative multidisciplinary input for up to 48 hours in order to facilitate intensive treatment, the engagement of appropriate allied health services and the streamlining of care-planning processes.

Guidelines and self-assessment tool

The Observation medicine guidelines 2009 outlines key principles for observation medicine as well as planning, implementation and operational service parameters for observation medicine units. It also details funding and service monitoring arrangements.

A self-assessment tool has been developed to support implementation and operation of observation medicine units. It assists in identifying priority elements for action and outlines ongoing quality monitoring processes.

The Department of Health & Human Services has released guidelines - Role of medical assessment and planning units in Victorian health services. They identify the characteristics that are integral to the effectiveness of a MAPU.