Establishing a Clinical Decision Unit for Observation Care in the Emergency Department

  • 2013

Establishing a Clinical Decision Unit for Observation Care in the Emergency Department

Author:
Diane M. Leach
Abstract:

The expanded use of observation care was evaluated as an adjunct to current practices to address high census and care delivery issues impacting the Emergency Department (ED) at Fletcher Allen Health Care (FAHC). This paper outlined the purpose, rationale, and objectives supporting the recommendation to create a designated unit to provide observation care, substantiated by an extensive literature review with current best clinical practices and outcome measurements outlined. Applicable leadership, organizational behavior, and planned change theories were delineated to support this effort. Lastly, potential strategies for implementation were summarized with key considerations for physical location, staffing, and administrative oversight provided. Advantages and disadvantages of these distinct options were offered. A suggested action plan, including a communication strategy and educational requirements, was provided with strong recommendations that an adjacent ED clinical unit with ED management and oversight would be advantageous to the institution.