Staffing and Management - Observation Unit

EPMG recognizes the value of Observation Units in the evaluation of a specific population of patients presenting to the emergency department. When utilized effectively, benefits to the hospital include:

• Decreased inpatient denials.
• Cost-effective opportunity for negotiating contracts with managed care and third party administrators.
• New referral base in the appropriate setting for outpatient studies, home care, and rehab.
• New opportunities with long-term care facilities.
• Increased revenue without increasing patient numbers; one patient - two encounters.
• Cardiac patients are the most expensive litigation against emergency physicians, comprising 20% of all dollars paid for malpractice. An Observation Unit provides a third option for disposition, allowing for decreased malpractice claims, and lower malpractice rates.
• The Observation Unit provides a safe continued evaluation (maximum of twenty-three hours) past the "reasonable" period in the emergency department without a traditional admission.
• Increased satisfaction in the emergency department as patient flow improves and waiting times are shortened.
• Appropriate management of inpatient beds.

The typical diagnoses found in an Observation Unit are chest pain, congestive heart failure, asthma, abdominal pain, and transient ischemic attacks (TIA's). Efforts are focused on a concentrated, streamlined approach with a usual timeframe of twelve to eighteen hours for a full work-up of the patient's chief complaint. This additional time outside the emergency department, but not as an inpatient, allows for a safe, appropriate medical plan of care to be developed for these patients with the correct disposition.