As a major acute teaching hospital serving a population of around 500,000 people, the RIE estimated its busy A&E department was seeing 70 fewer patients a day than optimum. People were waiting in A&E for treatment for injuries or conditions which would be better dealt with elsewhere, placing the department under pressure. Due to the high volume of people, privacy was also sometimes difficult to maintain.
To help manage patient flow, it was decided that a Minor Injuries Unit (MIU) would be created alongside the hospital’s A&E department. The new MIU would treat those with less serious injuries, diverting them away from A&E to a more suitable environment.
The Royal Infirmary of Edinburgh needed help with establishing a temporary ward to house an MIU. In consultation with the hospital’s staff, our team worked with NHS Lothian to determine their exact requirements and were able to offer a bespoke solution that met the hospital’s needs while also using both the existing estate and our fleet creatively.
The solution combined an existing our mobile laminar flow theatre with a number of modular buildings to create a suite of bespoke spaces. The end-to-end consultation process meant the project could deliver a complete clinical environment where patients could be booked in, prepared, have their treatment and recover, providing a seamless experience for the patient.
Converting one of our existing mobile theatres, we coupled this with a custom-built modular ward to create a unique assessment and treatment solution. The newly created stand-alone unit provides all the space the hospital needs to deliver an MIU service for its patients, including a reception and waiting area, treatment room, plaster room, eye wash room, six treatment bays, clean and dirty utility spaces, lavatories and a changing room.
The converted theatre unit was driven and unloaded onto the pre-determined location beside A&E, while the ward element was lifted into position on site by crane. It was important also that the department was accessible from the existing A&E, something which has been achieved through the building of a purpose-built walkway which brings the two departments together.
The unit was expected to initially be on site for two years and the service runs 24-hours-a-day, seven days a week. It is supported by a Operating Department Practitioner who facilitates alongside NHS Lothian’s existing staff team.
Within hours of opening, the impact was already apparent. In its first hour, more than 20 patients were diverted from A&E to the MIU, and within its first week upwards of 100 people a day were being seen and treated in the unit.
To date, more than 3,500 patients have received treatment for a range of injuries and conditions, such as fractures, sprains, back and neck pain, soft tissue injuries, bites and other minor ailments. Those people would previously have been seen in A&E under less than optimum conditions and facing a longer wait.
Staff working in the department report that A&E is much calmer and quieter and people can be seen quicker and with more privacy. There is greater privacy also for the people using the MIU, as the bays have fixed walls. The clinical team are enjoying working within the new unit, which is bright and spacious, well-equipped and has flexible space for triage, consultation and treatment.