This is the recommendation of a multidisciplinary performance improvement team to address out long length of stay for Observation status patients, and the need to expedite patient discharges to accommodate the needs of the Emergency Department. Locationįor more information, please call 312.996.7296. The Clinical Decision Unit (CDU) is a six bed unit for selected Observation status patients. Please contact your insurance provider to better understand the implications of being placed into the CDU. Insurance copays and deductibles, along with any additional costs, will be determined by the patient’s insurance policy terms. Outpatient observation stay is billed as outpatient services. Since patients in the CDU receive a rapid workup, they generally: After providing all necessary diagnostic tests, medications, and therapies, physicians will usually be able to make a decision about admitting the patient to the hospital or discharging them within one day, though patients may sometimes be required to stay in the observation unit for up to 48 hours. While in the CDU, patients will be regularly assessed by a multidisciplinary care team of physicians, nurse practitioners, and other clinical professionals. ![]() This new unit, also referred to as an observation unit, marks UI Health’s ongoing effort to improve patient experience by centralizing care for patients. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.The Clinical Decision Unit (CDU) at UI Health is a designated area within the hospital that allow our providers to monitor and evaluate the medical condition of patients who do not meet criteria for inpatient admission but are not well enough to go home without require further observation. The substantial improvements in ambulance ramping and escalations also indicated that the department was able to cope better with periods of high activity.Įfficiency emergency medicine hospital organisational emergency service. In summary, this ED led, consultant run CDU model of care resulted in significantly improved performance on a range of KPIs, including improvement in access block and NEAT figures. The percentage of patients that did not wait and 30 day representations showed a small but statistically significant decrease. Overall there was no change to hospital mortality numbers. Total ambulance ramping time fell by 58% and ambulance service level three escalations fell from 21 to 5 post-CDU implementation. There was a significant improvement in NEAT adherence. Primary outcomes were access block (percentage of patients admitted >8 h), discharge National Emergency Access Target (NEAT) adherence and Queensland Ambulance Service level three escalations.Īfter the implementation of the CDU, access block significantly improved. This present study describes the impact of a new model of care using an ED led, consultant run clinical decision unit (CDU) on performance, using a retrospective analysis of data for 9 month periods before and after the introduction of the CDU model of care. Interviews were tape-recorded and later transcribed verbatim. In-depth semi structured interview was conducted with each participant to assure further understanding of the way participant shaped their clinical decisions in critical care units. Multiple models of care have been studied in an effort to improve access block and other key performance indicators (KPIs) of ED. About 150 hours of observations were spent in the involved intensive care units. ED access block is an ongoing significant problem and has been associated with excess mortality.
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