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Implementation of a hospitalist-run observation unit and impact on length of stay (LOS): A brief report

✍ Scribed by Luci K. Leykum; Vincent Huerta; Eric Mortensen

Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
109 KB
Volume
5
Category
Article
ISSN
1553-5592

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✦ Synopsis

Abstract

BACKGROUND:

While the impact of hospitalists on length of stay (LOS) for inpatient medicine services has been studied, there has been little work on the impact of hospitalist involvement in short‐stay or observation units.

OBJECTIVE:

The primary objective was to examine the impact of a hospitalist‐run observation unit on LOS. The secondary objective was to assess utilization of the unit through examining case‐weight and LOS.

DESIGN:

Retrospective cohort study with a preimplementation/postimplementation analysis.

SETTING:

University Hospital, the 604‐bed teaching hospital for Bexar County, San Antonio, Texas.

PATIENTS:

All patients discharged from the inpatient medicine and observation units with diagnoses of chest pain, asthma, syncope, cellulitis, and pyelonephritis.

INTERVENTION:

Creation of a hospitalist‐run, nonteaching, 10‐bed “Clinical Decision Unit” (CDU).

MEASUREMENTS:

The overall LOS of the “top 5” most common diagnoses was compared for the 12 months preimplementation and postimplementation of the unit.

RESULTS:

The overall LOS for all patients decreased from 2.4 to 2.2 days (P = 0.05) between the 12 months preimplementation and postimplementation. The greatest decreases were seen for cellulitis (2.4‐1.9 days; P < 0.001) and asthma (2.2‐1.2 days; P < 0.001).

CONCLUSIONS:

Implementation of a hospitalist‐run observation unit was associated with a significantly decreased LOS for all patients regardless of location, suggesting that the unit has led to more efficient care. Journal of Hospital Medicine 2010; © 2010 Society of Hospital Medicine.

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