Research and innovation

As a non-disease based specialty, AIM research focuses on the risk stratification of the acutely unwell patient, as well as the implementation of care and care processes, such as patient flow. The Society for Acute Medicine (SAM) has a research committee which supports innovation.

There is huge potential for research in AIM. Dealing with a heterogeneous population and a wide spectrum of diseases, AIM is ideally placed to identify patients for research studies, for example in thromboembolic disease. Most AMUs have presented local projects at SAM’s scientific meetings. Every AMU should have a designated consultant acute physician responsible for research and development. With a focus on multiprofessional working, AMUs should encourage collaborative projects and participate in traditional multicentre studies.

Areas where AMUs can excel include:

  • risk stratification of acutely unwell patients – especially in patients with common and/or poorly defined presentations, such as chest pain or falls
  • use of new technology in the diagnosis of acute illness – such as novel scanning techniques, biomarkers and algorithms to make an earlier and more accurate diagnosis in patients presenting with undifferentiated disease
  • patient flow
  • qualitative research – to understand how care can be better delivered and how the social models of care function, especially across professional boundaries
  • big data – with the high number of patients passing through AMUs and ambulatory emergency care (AEC) there is a large amount of data to be collected. For example, the seminal work of Dr Bernard Silke in Ireland, who collected simple measures of outcome in thousands of patients over many years [1] , [2]
  • national audits and benchmarking – SAM runs an annual benchmark audit in which all AMUs are eligible to participate (SAMBA – Society for Acute Medicine Benchmark Audit). SAM also invites all AMUs to participate in web-based surveys and audits.

AMUs are frequently well placed to translate research into practice, for example acute kidney injury and sepsis. Hospitals and trusts should support this evolving area of innovation. With the pressures on our acute services at historically high levels, it is logical to seek scientific solutions. National funding for research in AIM, for example from the National Institute for Health Research (NIHR), is still in its infancy, further emphasising the need for local support.

[1] Moloney ED, Bennett K, Silke B. Effect of an acute medical admission unit on key quality indicators assessed by funnel plots. Postgrad Med J 2007;83:659–663.