What is an Accountable Care Unit?

An Accountable Care Unit is a geographic inpatient care area consistently responsible for the clinical, service, and cost outcomes it produces.

The ACU care model assigns physicians to a primary unit where they perform Structured Interdisciplinary Bedside Rounds (SIBR® rounds) with each patient’s nurse and the rest of the care team. Organizing care teams by units creates predictability, cohesiveness, and better communication.

An Accountable Care Unit has four key features:

  1. Unit-Based Teams
  2. SIBR® rounds
  3. Unit-Level Performance Reporting
  4. Unit-Level Nurse and Physician Co-Leadership

Care teams in an Accountable Care Unit develop relationships based on mutual respect and shared accountability that are the foundation for proactive, high-performing teams. High-performing teams are able to coordinate care plans and recognize and respond quickly and efficiently to staff and patient needs, including clinical deterioration.

Why Accountable Care Units?

People are a hospital’s greatest asset, but traditional models of care are reactive, preventing health professionals from working at their potential and allowing obstacles to collaboration and efficiency to persist. Hospitals are plagued by underperformance and preventable adverse events that result from failures to initiate and intensify care, standardize or customize care to meet the needs of each patient and their families, and communicate and pursue a plan of care unambiguously across units, shifts, and team members.

Why is that?

Because hospitals were never engineered to create a proactive environment where front-line staff can come together as high-performing teams that bring out the best of each staff member every day.

Accountable Care Units change that by reengineering how a hospital floor is organized. Accountable Care Units make it possible to create high-performing teams that anticipate and prevent complications — and recognize and respond as early as possible when complications do happen.

When evaluated against the failing status quo, the question quickly changes from “Why do we need proactive care or Accountable Care Units?” to “How can we afford not to be proactive?”

Wherever leadership and staff are committed to patients, families, and each other Accountable Care Units will become the standard of care.

What outcomes can be expected from an Accountable Care Unit?

Accountable Care Units are designed so a unit can perform at its proactive best. Outcomes in Accountable Care Units are a function of the unit’s patient population, baseline unit performance, the focus and effectiveness of ACU leadership, and the moment-to-moment performance of every contributing team member. Accountable Care Units in the US and around the world have demonstrated improved clinical, cost, utilization, service, and educational outcomes.

  • Clinical Outcomes: The ACU care model has been associated with reductions in in-hospital mortality and complications of care
  • Cost and Utilization Outcomes: Accountable Care Units have described reductions in cost-of-care, 30-day readmissions, and length-of-stay as well as improved utilization of telemetry and medications.
  • Service and Educational Outcomes: Greater employee engagement scores, patient satisfaction, culture of safety, and professional teamwork competencies are widely seen in Accountable Care Units.

What problems do Accountable Care Units solve?

Accountable Care Units are a convergent solution because proactive, high-performing teams are at the heart of almost every problem a hospital needs to solve, including:

  • Developing a culture of safety, respect, and accountability
  • Increasing productivity and reliability of frontline professionals
  • Delivering patient-centered care
  • Ensuring nurses perform critical thinking
  • Formulating an interdisciplinary plan of care for every patient every day
  • Formulating a discharge plan for every patient every day
  • Increasing face-to-face communication and reducing reliance on chart-based, phone, text, and paging communication

What are SIBR® rounds?

SIBR® rounds synchronize proactive communication and care planning by the responsible physician, bedside nurse, allied health professionals, and the family at the bedside. When synchronized and using a standard format that makes sense to everyone involved, physicians and nurses can exchange information crisply and efficiently.

What does it take to launch an Accountable Care Unit?

To launch an Accountable Care Unit, simply put the ACU™ Platform in the hands of unit leaders, with or without the additional support of a project manager.

The ACU™ Platform offers everything need for successful implementation, from training and tracking to grow frontline performance, to all the project and change management resources needed for a smart, coordinated launch.

What types of hospitals have implemented Accountable Care Units?

The ACU™ care model has been implemented successfully in both community and teaching hospitals.

What types of units have implemented Accountable Care Units?

The ACU™ care model has been implemented successfully in the widest variety of units including medical and surgical units; acute, progressive, and intensive care units; emergency, rehab, and long term acute care units; and across a range of populations from geriatric to pediatric and psychiatric patients.