Saturday, April 1, 2017
Welcome!
This blog is dedicated to Dixie Regional Medical Center's Observation Unit. This unit opened August 2016. My objective for this blog is to let co-workers, patients, and the community know what the Observation Unit's function and goals are.
What is the Observation Unit?
The observation unit is an outpatient area within Dixie Regional Medical Center where a dedicated healthcare team will determine if patients need admission to the hospital, or if they can be safely discharged home with follow up care by their primary care physician. It is our intention to make the determination within 24 hours of you arriving in the unit. This is why this unit is great for chest pain patients to trend troponin levels, and also great for patients who need 24 hour IV antibiotics. Because of this goal of discharge within 24 hours, heparin drips and titratable drips are not ideal for this unit. These medications are usually ordered for more than 24 hours and the patient is not typically ready for discharge after 24 hours. Another goal of this unit is to help free up admit beds throughout the hospital. The observation unit has 12 useable beds. One unique thing about the observation unit is that there is a Nurse Practitioner on the unit from 7am-7pm seven days a week. This helps people get discharged quicker, and admitted quicker. Because we are trying to get our patients discharged quickly, we have to make sure all the tests get done and read quickly. This unit is fast paced and there are many admits and discharges every day.
Treatment Goals
What we tell our patients: while in the observation unit, the team will focus on the most pressing issue that led to your presentation to the Emergency Department. This may require additional diagnostic testing, medications, and physician consults as the time determines the next steps in your plan of care. Occasionally you may have secondary medical issues you'd like to discuss. If it's possible we will attempt to address those concerns wile you are here. Often times, however, you will need to follow up with your primary care physician to help you with those concerns. If you do not have a primary care provider, we can provide you with referral information.
Behind the scenes: most of our patients in the observation unit have diagnoses of syncope, TIA, and chest pain. These three types of patients have diagnostic tests that can determine if they need to be admitted or discharged within 24 hours. Our unit is like every other unit, just quicker. We have physical therapy, occupational therapy, neurological hospitalists consults, MRI, CT, nuclear medicine heart stress tests, and many other diagnostic tests. We don't wait around for these tests to be done, a lot of the time we are paging the people that need do the tests in order to get them done quicker. We have to be proactive on getting our patients admitted or discharged.
Behind the scenes: most of our patients in the observation unit have diagnoses of syncope, TIA, and chest pain. These three types of patients have diagnostic tests that can determine if they need to be admitted or discharged within 24 hours. Our unit is like every other unit, just quicker. We have physical therapy, occupational therapy, neurological hospitalists consults, MRI, CT, nuclear medicine heart stress tests, and many other diagnostic tests. We don't wait around for these tests to be done, a lot of the time we are paging the people that need do the tests in order to get them done quicker. We have to be proactive on getting our patients admitted or discharged.
Research
There is countless research done regarding the benefits of observation unit's across the country.
"Clinical observation units were initially created to minimize Medicare payment denials for questionable admissions or short inpatient stays. With the rise of managed care, these units also can contribute to ensuring optimal reimbursement by helping manage patient flow. Hermann Hospital initially opened an observation unit in 1992"
"Compared to patients receiving observation services elsewhere in the hospital, patients cared for in observation units with defined protocols, have a 23-28 percent shorter lengths of stay, a 17-44 percent lower probability of subsequent inpatient admission, and $950 million in potential national cost savings each year. Furthermore, we estimate that 11.7 percent of short-stay inpatients nationwide could be treated in an observation unit, with possible savings of $5.5-$8.5 billion annually"
"It is estimated that if hospitals without observation units had them in place, the average cost savings per patient would be $1,572, the annual hospital savings would be $4.6 million, and the national cost savings would be $3.1 billion"
The observation unit at Dixie Regional Medical Center saves the hospital money, and frees up inpatient beds. There are no downfalls to the observation unit. Our goal is to contribute to the greatness of Dixie Regional Medical Center and to help out in any way.
References:
Baugh, C. W., Venkatesh, A. K., Hiltion, J. A., Samuel, P. A., Schuur, J. D., & Bohan, J. S. (2012). Making greater use of dedicated hospital observation units for many short-stay patients could save #3.1 billion a year. Health Affairs. 3(10), 2314-2315.
Lenox, A. C., & New, H. (1997). Clinical observation units help manage costs and care. Healthcare Financial Management 51(4). 88-9.
Ross, M. A., Hockenberry, J. M., mUtter, R., Barrett, M., Wheatley, M., & Pitts, S, R., (2013). Protocol-driven emergency department observation units offer savings, shorter stays, and reduced admissions. Health Affairs, 32(12), 2149-56.
"Clinical observation units were initially created to minimize Medicare payment denials for questionable admissions or short inpatient stays. With the rise of managed care, these units also can contribute to ensuring optimal reimbursement by helping manage patient flow. Hermann Hospital initially opened an observation unit in 1992"
"Compared to patients receiving observation services elsewhere in the hospital, patients cared for in observation units with defined protocols, have a 23-28 percent shorter lengths of stay, a 17-44 percent lower probability of subsequent inpatient admission, and $950 million in potential national cost savings each year. Furthermore, we estimate that 11.7 percent of short-stay inpatients nationwide could be treated in an observation unit, with possible savings of $5.5-$8.5 billion annually"
"It is estimated that if hospitals without observation units had them in place, the average cost savings per patient would be $1,572, the annual hospital savings would be $4.6 million, and the national cost savings would be $3.1 billion"
The observation unit at Dixie Regional Medical Center saves the hospital money, and frees up inpatient beds. There are no downfalls to the observation unit. Our goal is to contribute to the greatness of Dixie Regional Medical Center and to help out in any way.
References:
Baugh, C. W., Venkatesh, A. K., Hiltion, J. A., Samuel, P. A., Schuur, J. D., & Bohan, J. S. (2012). Making greater use of dedicated hospital observation units for many short-stay patients could save #3.1 billion a year. Health Affairs. 3(10), 2314-2315.
Lenox, A. C., & New, H. (1997). Clinical observation units help manage costs and care. Healthcare Financial Management 51(4). 88-9.
Ross, M. A., Hockenberry, J. M., mUtter, R., Barrett, M., Wheatley, M., & Pitts, S, R., (2013). Protocol-driven emergency department observation units offer savings, shorter stays, and reduced admissions. Health Affairs, 32(12), 2149-56.
In Conclusion
The observation unit's staff is a hard-working, dedicated group of individuals. We love our job and our patients are our priority. While the observation unit is a professional environment, we also have fun. We want our patients to feel at home and we want ensure that they are getting the care they need. We love our patients and we love our unit. For any further questions regarding the observation unit, you can call Dixie Regional Medical Center at 25-2992.
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