Asthma and Emergency Department Observation Units

1999 ◽  
pp. 542-549 ◽  
Keyword(s):  
Emergency Department ◽  
Observation Units

scholarly journals Emergency Department Observation Units and the Older Patient

2013 ◽  
Vol 29 (1) ◽  
pp. 71-89 ◽  
Author(s):  
Mark G. Moseley ◽  
Miles P. Hawley ◽  
Jeffrey M. Caterino
Keyword(s):  
Emergency Department ◽  
Older Patient ◽  
Observation Units

Predicting the risk of reattendance for acute heart failure patients discharged from Spanish Emergency Department observation units

2010 ◽  
Vol 17 (4) ◽  
pp. 197-202 ◽  
Author(s):  
Òscar Miró ◽  
Pere Llorens ◽  
Francisco Javier Martín-Sánchez ◽  
Pablo Herrero ◽  
Javier Jacob ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Heart Failure ◽  
Heart Failure Patients ◽  
Observation Units

scholarly journals Protocol-Driven Emergency Department Observation Units Offer Savings, Shorter Stays, And Reduced Admissions

2013 ◽  
Vol 32 (12) ◽  
pp. 2149-2156 ◽  
Author(s):  
Michael A. Ross ◽  
Jason M. Hockenberry ◽  
Ryan Mutter ◽  
Marguerite Barrett ◽  
Matthew Wheatley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Observation Units

scholarly journals A National Dataset Analysis of older adults in emergency department observation units

2019 ◽  
Vol 37 (9) ◽  
pp. 1686-1690
Author(s):  
Lauren T. Southerland ◽  
Katherine M. Hunold ◽  
Christopher R. Carpenter ◽  
Jeffrey M. Caterino ◽  
Lorraine C. Mion
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Observation Units ◽  
Dataset Analysis

238: An Analysis of Emergency Department Observation Units Impact on Patient Satisfaction Scores

2009 ◽  
Vol 54 (3) ◽  
pp. S74-S75
Author(s):  
A. Chandra ◽  
D. Harrison ◽  
A. Boardwine ◽  
J. Villani ◽  
C. Gerardo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Observation Units ◽  
Patient Satisfaction Scores

scholarly journals Post-discharge Acute Care and Outcomes in the Era of Readmission Reduction

2019 ◽  
Author(s):  
Rohan Khera ◽  
Yongfei Wang ◽  
Susannah M. Bernheim ◽  
Zhenqiu Lin ◽  
Harlan M. Krumholz
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Acute Care ◽  
Care Utilization ◽  
Post Discharge ◽  
Readmission Rates ◽  
Risk Of Death ◽  
Observation Units ◽  
Acute Care Utilization ◽  
Significant Change

ABSTRACTBackgroundWith incentives to reduce readmission rates, there are concerns that patients who need hospitalization after a recent hospital discharge may be denied access, which would increase their risk of mortality.ObjectiveWe determined whether patients with hospitalizations for conditions covered by national readmission programs who received care in emergency department (ED) or observation units but were not hospitalized within 30 days had an increased risk of death. We also evaluated temporal trends in post-discharge acute care utilization in inpatient units, emergency department (ED) and observation units for these patients.Design, Setting, and ParticipantsIn this observational study, national Medicare claims data for 2008-2016, we identified patients ≥65 years hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia, conditions included in the HRRP.Main Outcomes and MeasuresPost-discharge 30-day mortality according to patients’ 30-day acute care utilization. Acute care utilization in inpatient and observation units, and the ED during the 30-day and 31-90-day post-discharge period.ResultsThere were 3,772,924 hospitalizations for HF, 1,570,113 for AMI, and 3,131,162 for pneumonia. The overall post-discharge 30-day mortality was 8.7% for HF, 7.3% for AMI, and 8.4% for pneumonia. Post-discharge mortality increased annually by 0.16% (95% CI, 0.11%, 0.22%) for HF, decreased by 0.15% (95% CI, -0.18%, -0.12%) for AMI, and did not significantly change for pneumonia. Specifically, mortality only increased for HF patients who did not utilize any post-discharge acute care, increasing at a rate of 0.16% per year (95% CI, 0.11%, 0.22%), accounting for 99% of the increase in post-discharge mortality in heart failure. Concurrent with a reduction in 30-day readmission rates, 30-day observation stays and visits to the ED increased across all 3 conditions during and beyond the post-discharge 30-day period. There was no significant change in overall 30-day post-acute care utilization (P-trend >0.05 for all).Conclusions and RelevanceThe only condition with an increasing mortality through the study period was HF; the increase preceded the policy and was not present among those received ED or observation unit care without hospitalization. Overall, during this period, there was not a significant change in the overall 30-day post-discharge acute care utilization.

Abstract 220: Impact of a Cardiology-managed, Non-emergency Department, Outpatient Observation Unit

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Karen Cajiao ◽  
Joseph Wallins ◽  
Peter Zimetbaum ◽  
Michael Gavin
Keyword(s):  
Emergency Department ◽  
Discharge Rate ◽  
Medical Center ◽  
Tertiary Care ◽  
Direct Access ◽  
Observation Units ◽  
Phone Calls ◽  
Final Disposition ◽  
Made In

Background: With the progress emergency department (ED) observation units have made in reducing admissions for cardiac conditions, we previously reported a discharge rate of only 23.7% (n=1,549/6,546) from our ED, without an observation stay, for these patients. We opened a Cardiac Direct Access (CDAc) unit at a tertiary care urban medical center hypothesizing that cardiologists can reduce testing and observation stays for appropriate cardiac patients. Methods: Patients are referred to the CDAc for evaluation on an emergent (same day) or urgent (within 7 day) basis. We performed a retrospective review of 629 consecutive patients referred to the CDAc between November 2016 and June 2017. Final disposition was determined using charge data. The 30-day return rate to an ED, hospital, or the CDAc was determined by follow-up phone calls and chart review. Results: Patients were referred by non-cardiologists (n=403/629, 64%) and cardiologists (n=226/629, 36%). The most common indications for evaluation were chest pain, arrhythmia, and suspected heart failure. Disposition of patients evaluated in the CDAc are reported in the figure. The mean length of stay in CDAc observation was 22+/-13 hours. Among the 574 patients discharged from the CDAc, 62 (11%) were seen in an ED and/or hospitalized, while 31 (5.4%) were seen in the CDAc within 30 days. Conclusion: A CDAc unit may serve as a high value alternative to the ED. Further research can help assess comparative cost-effectiveness and refine patient selection.

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