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Recommended Citation
Pleasance A, Radtke S. Observation Unit Redesign: Strategies to Speed Up Discharge. Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background
A busy Level 1 Trauma center redesigned their Observation Unit workflow, utilizing an interdisciplinary team to test new strategies to proactively engage patients/family and teammates to efficiently meet 24- and 48-hour discharge goals and improve throughput.
Local Problem
Observation units are used to reduce ED overcrowding and provide focused, rapid treatment for patients diagnosed with conditions that can be managed within 24 to 48 hours. At baseline, only 33% of the hospital observation patients were discharged within 24 hours with only 81% discharged within 48 hours. These rates were below the targets set by the healthcare system.
Methods
The Observation Unit redesign was led by an interdisciplinary team, consisting of a physician, care manager, charge nurse, unit manager, and clinical staff, who implemented multiple strategies to optimize the workflow. An electronic tracking board was utilized to display ‘hours in observation’ to help the team prioritize care. The new workflow engaged the patient and family on admission in planning care focused on discharge needs and transportation. Daily interdisciplinary care rounds are held to review the plan of care and ensure the timely completion of tests and procedures. Charge nurses reach out to specialists for timely consults. The Unit manager works to reduce any barriers.
Results/Conclusions
Three months into the redesign, the hospital’s 24-hour observation discharge rate improved by 33% (up to 44%) with a 48-hour discharge rate at 90% and observation patient length of stay averaging 29 hours. Utilizing these new workflows, the Observation Unit is now meeting/exceeding targets set by the healthcare system.
Implications for Practice
The dedicated Observation Unit, interdisciplinary team and a redesigned workflow was successful in achieving and sustaining improved discharge rates. Hospital leaders continue to work to increase Observation Unit capacity to achieve best outcomes.
Document Type
Poster
Publication Date
11-13-2024
Observation Unit Redesign: Strategies to Speed Up Discharge
Background
A busy Level 1 Trauma center redesigned their Observation Unit workflow, utilizing an interdisciplinary team to test new strategies to proactively engage patients/family and teammates to efficiently meet 24- and 48-hour discharge goals and improve throughput.
Local Problem
Observation units are used to reduce ED overcrowding and provide focused, rapid treatment for patients diagnosed with conditions that can be managed within 24 to 48 hours. At baseline, only 33% of the hospital observation patients were discharged within 24 hours with only 81% discharged within 48 hours. These rates were below the targets set by the healthcare system.
Methods
The Observation Unit redesign was led by an interdisciplinary team, consisting of a physician, care manager, charge nurse, unit manager, and clinical staff, who implemented multiple strategies to optimize the workflow. An electronic tracking board was utilized to display ‘hours in observation’ to help the team prioritize care. The new workflow engaged the patient and family on admission in planning care focused on discharge needs and transportation. Daily interdisciplinary care rounds are held to review the plan of care and ensure the timely completion of tests and procedures. Charge nurses reach out to specialists for timely consults. The Unit manager works to reduce any barriers.
Results/Conclusions
Three months into the redesign, the hospital’s 24-hour observation discharge rate improved by 33% (up to 44%) with a 48-hour discharge rate at 90% and observation patient length of stay averaging 29 hours. Utilizing these new workflows, the Observation Unit is now meeting/exceeding targets set by the healthcare system.
Implications for Practice
The dedicated Observation Unit, interdisciplinary team and a redesigned workflow was successful in achieving and sustaining improved discharge rates. Hospital leaders continue to work to increase Observation Unit capacity to achieve best outcomes.
Affiliations
Advocate Good Samaritan Hospital