Document Detail

Maximizing use of the emergency department observation unit: a novel hybrid design.
MedLine Citation:
PMID:  11223762     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: We sought to determine whether sharing an observation unit with scheduled procedure patients would maintain a more consistent unit census and patient/nurse ratio. A secondary objective was to determine the effect of this model on patient length of stay and discharge rates. METHODS: This retrospective, descriptive study was conducted in a high-volume suburban teaching hospital, using a "before-and-after" study design. A "pure" postprocedure unit became a "hybrid" observation postprocedure unit by displacing specific postprocedure patients to inpatient locations. Subsequently, the displaced patients were returned to the unit. On weekends, the unit operated as a pure observation unit. Hourly unit occupancy and census data were prospectively collected, and hourly patient/nurse ratios were calculated. Patient length of stay and discharge data were collected and compared in different settings. RESULTS: The 2 services showed a complementary census pattern that allowed the hybrid unit to maintain an average hourly patient/nurse ratio of 3.7 compared with the ratio of 2.5 for a pure observation unit. There was no difference in observation patient length of stay (14.8 hours versus 14.7 hours) or discharge rate (20.4% versus 18.1%) between weekdays and weekends. However, scheduled procedure patients experienced significantly shorter lengths of stay in the hybrid unit setting (4.3 hours) than in alternative inpatient locations (9.4 hours). CONCLUSION: The hybrid model showed better hourly census and nurse resource use rates, with no adverse effect on observation patients. However, scheduled procedure patient length of stay was shorter in this setting.
M A Ross; S Naylor; S Compton; K A Gibb; A G Wilson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  37     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-06     Completed Date:  2001-03-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  267-74     Citation Subset:  AIM; IM    
Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA.
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MeSH Terms
Bed Occupancy / economics
Cost Savings
Emergency Service, Hospital / economics,  organization & administration*
Hospitals, Teaching
Length of Stay / economics
Patient Care Team / economics,  organization & administration
Patient Discharge / economics
Prospective Studies
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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