Making acuity-adaptable units work: Lessons from the field

Objective: Because there have been no clear directions on how to implement acuity-adaptable units (AAUs), this paper describes actual tactics and strategies that have worked in multiple institutions. Background: AAUs have been used in hospitals for the past decade, but reports in the literature have indicated both successes and difficulties in meeting operational goals and objectives. Despite various views regarding acuity adaptability, there is little in the literature that suggests why it works in some hospitals and not in others. Method: As part of a larger construction project, this project team interviewed the leaders of six hospitals to determine what was associated with the successful implementation of AAUs. Results: This paper reports on themes that emerged from these interviews, namely: choose the right specialty for medical centers; adopt theAAU model for the entire facility in community hospitals; bring in and train the right people; change culture through communication; and use acuity-adaptable unit clusters. Discussion and Conclusions: Main themes, predictable patient progress, and culture change are further discussed and key recommendations are described.