Reorganizing a hospital ward as an accountable care unit

Stein, J., Payne, C., Methvin, A., Bonsall, J.M., Chadwick, L., Clark, D., Castle, B.W., Tong, D. & Dressler, D.D.


When Emory University Hospital reorganized a high-acuity 24-bed medical unit into an Accountable Care Unit, they significantly improved patient outcomes, reducing in-hospital mortality from 2.3% to 1.1% and shortening average length of stay from 5.0 to 4.5 days.

0 %
reduction in in-hospital mortality
0 %
reduction in Length of Stay


To reorganize a traditional hospital ward into an Accountable Care Unit (ACU) to enhance clinical efficiency and effectiveness through improved teamwork and communication.


The ACU model was implemented using four key features: unit-based teams, structured interdisciplinary bedside rounds (SIBR), unit-level performance reporting, and nurse-physician co-leadership, evaluated over a four-year period at Emory University Hospital.


Following the implementation of the ACU, the unit saw a significant reduction in in-hospital mortality from 2.3% to 1.1% and a decrease in average length of stay from 5.0 days to 4.5 days.


The reorganization of the hospital ward into an ACU significantly improved patient outcomes and operational efficiency, demonstrating the value of structured team-based care models in high-acuity medical settings.

Additional Data

Subsequent analysis of in-hospital deaths showed a significant reduction after for the adoption of the ACU care model and SIBR rounds on the study unit and a second unit.

I hope you enjoyed reading these strong results. Unit outcomes like these are achievable within 3 to 6 months using a seasoned implementation methodology:

  1. skillful project management
  2. smooth training and launch, and a
  3. long-term partnership for sustainability.

One option to achieve similar results is to engage our 1Unit experts. Backed by 15 studies like this one, our work has received awards from The Joint Commission, CMS, Clinical Excellence Commission, IHI, BMJ, and the Society of Hospital Medicine.

Whether your unit(s) have current multidisciplinary rounds or not, our experts can guide your unit leaders to launch and sustain the best interdisciplinary teamwork and communication you’ve ever seen on a hospital ward.

This is not some ivory tower theory. Our methods have been toughened and refined worldwide. Everything we teach has been carefully tested over more than a decade, so we know it works.

Connect with us if you’d like the “Easy Button” to steadily reduce harm events, discharge delays, and patient and staff dissatisfiers.

Liam Chadwick, PhD