Cognitive screening of older patients in a teaching hospital: the impact of the Rapid Assessment Medical Unit (RAMU)

Background: The Rapid Assessment Medical Unit (RAMU) is a short stay processing ward for general medical patients. Aim: To evaluate the impact of the RAMU on cognitive screening of older medical patients. Method: Audit of documentation of cognition using a validated screening tool in the medical records of 500 patients aged 70 years and older. Their admission records under general medicine in the preceding 12 months were also reviewed. Results: Administration of the Abbreviated Mental Test (AMT) was attempted in 81% of patients. In 64.6% it was completed. 29% had impaired cognition on screening. A validated screening tool for cognitive assessment was recorded only in 7.6% of patients before the RAM U was opened. Conclusion: The work practice and procedural changes in the RAM U appear to have a positive impact on cognitive screening. This observation may suggest that evidence based clinical guidelines could be successfully implemented in a model similar to the RAMU.