Observation Unit Case Study
Presented by: Lauren Baker, Ben Krueger, Peter Carr, Erin Cheng Skye Weaver & Jessica White
Agenda
Areas of Focus
Current State of UAB
Industry Best Practices
Application to UAB
Recommendations
A best practice guide for the development of a dedicated observation unit at UAB Hospital
Introduction
Introduction
Criteria of Observation Patients
Requires a minimum 4-6
hours of monitoring
Higher probability of
being discharged within 18
hours
Normal EKG and Lab Work
Chief complaint of chest pain or
related symptom
Inpatient admission is not clearly
needed
Patient Satisfaction
Quality of Care
Financial Outcomes
Patient Throughput
Main Issues
Current State of UAB
High Avg. Daily Census
Pending Throughput
Initiative
ED Very Busy
Current State of UAB
ED a Costly Care Delivery Setting
LOS for Potential Observation Patients >30
Hours
Mean Charge $12,900 Mean Collection $1,400
Industry Best Practices:
Emory’s Clinical Decision Unit
CDU Locations
Emory University Hospital
Emory Midtown Hospital
Grady Memorial Hospital
Attending ED
Physician
Associate Providers
Dedicated Nursing
Staff
Case Manager
Staffing Considerations
Operational Considerations
CDU Entrance
CDU Entrance
ED Entrance
ED Entrance
Annual CDU Visits – FY 2011
•1,639
Emory University Hospital
•2,616
Emory Midtown Hospital •1,775
Grady Memorial Hospital
Average Length of Stay
•16.6 Hours2009
•16 Hours2011
CDU Discharge Rates
•83%2009
•85%2011
Improving Quality at Emory
• Decreased rate of missed MI’s• Increase in hospital capacity
(fewer admissions)• Decrease in patients “left-
without-being-seen”• Decrease in ED diversion hours
Outcomes
Application to UAB
Cost
Savings
Financial
Application
Pilot: Innovation Board
ED Observation Unit
Full Implementation with ED Expansion
Recommendations
Requirements• Staffing• Hours• Space
Observation Unit Case Study
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