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Accountable Care Units

A Disruptive Innovation in Acute Care Delivery

Castle, Bryan W. BSN, MBA, RN; Shapiro, Susan E. PhD, RN, FAAN

doi: 10.1097/NAQ.0000000000000142
Original Articles

Accountable Care Units are a disruptive innovation that has moved care on acute care units from a traditional silo model, in which each discipline works separately from all others, to one in which multiple disciplines work together with patients and their families to move patients safely through their hospital stay. This article describes the “what,” “how,” and “why” of the Accountable Care Units model as it has evolved in different locations across a single health system and includes the lessons learned as different units and hospitals continue working to implement the model in their complex care environments.

Emory Healthcare, Atlanta, Georgia (Mr Castle); and Emory Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia (Dr Shapiro).

Correspondence: Bryan W. Castle, BSN, MBA, RN, Emory Healthcare, 550 Peachtree St NE, Orr Building Room 416, Atlanta, GA 30308 (

The authors acknowledge the pioneering work of Dr Jason Stein in developing the ACU model and SIBR.

This work is supported in part by grant # UD7HP26046 from Health Resources and Services Administration. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the Health Resources and Services Administration.

Mr Castle has received fees/honoraria for consulting on aspects of the Accountable Care Unit and Structured Interdisciplinary Bedside Rounds. The Accountable Care Unit and Structured Interdisciplinary Bedside Rounds are registered trademarks of Centripital and Emory University. The second author declares no conflict of interest.

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved