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Observation Medicine
An important goal of the EDOU is expedited care by carefully conceived protocols. The EDOU patients receive standard evaluations by ED physicians and nurses. In addition, full-time nurse practitioners evaluate, monitor, counsel, treat, and educate patients to ensure optimal patient care. In planning for the EDOU, protocols were developed for various diagnoses appropriate for the unit. Chest pain (the initial protocol) has expanded to over 30 protocols.
As hospitals across the country face escalating numbers of patient visits, the EDOU is a model unit that demonstrates a positive impact on in-patient telemetry bed utilization. In addition, efficient turnaround times of patients seen in the ED have helped alleviate ED overcrowding and excessive waiting times. We have participated in initiatives of national organizations that are at the forefront of observation medicine, including the Observation Medicine section of the American College of Emergency Physicians (ACEP) and the National Society of Chest Pain Centers. Diagnostic testing is done with similar urgency. The dedication of consultants and specialists combined with recognition of the importance of safe, high-quality, and efficient care by the hospital staff have resulted in an effective partnership to ensure excellence. In-patient stays of one to two days can be compressed to less than 24 hours in the EDOU. This is proof that one to two days can be compressed to less than 24 hours in the EDOU. This is proof that high quality patient care does go hand in hand with process improvement and fiscal stewardship. Documented patient satisfaction scores consistently at or above the 90% level validate our success. The EDOU provides an ideal environment for data acquisition, thereby facilitating total quality management, utilization review, and clinical research. We have developed criteria for total quality management and utilization review in the EDOU to improve patient care and track outcomes, and we report quarterly to the Emergency Department Quality Management (EDQM) Committee. In addition, research on chest pain, syncope, kidney stones, and cellulitis has been conducted or is ongoing. The EDOU is having a lasting impact on the way medicine is practiced at NMH. The quality, safety, and efficient care of patients, the increased in-patient bed availability (especially monitored beds), the improvement in patient waiting times and lengths of stay, and the expansion of research opportunities for the department are just a dew of the metics of success. Based on our strong commitment to patient care, we look forward to further improvements in the years to come. For questions about our department's observation unit, please contact director, Dr. David Zull. For more information about ongoing research in the observation unit, please click here for our research page. |
The EDOU was opened in 2003. This unit has 23 monitored beds located on the mezzanine of the Feinberg Pavilion, directly above the ED.
Fifty percent of EDOU admissions have cardiac diagnoses, though a wide spectrum of emergent conditions that have proven appropriate for management within the observation unit.