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Chapter 80 - The Evidence Basis for Observation Medicine in Adults Based on Diagnosis/Clinical Condition

from Part VII - Evidence Basis for Observation Medicine

Published online by Cambridge University Press:  31 March 2017

By
Christopher W. Baugh ,
Sharon E. Mace ,
Margarita E. Pena  and
J. Stephen Bohan
Edited by
Sharon E. Mace
Sharon E. Mace
Affiliation:
Department of Emergency Medicine, Cleveland Clinic, Ohio
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Summary

Abstract

This chapter deals with critical issues in observation medicine for adult patients based on a given diagnosis or clinical condition, such as chest pain or asthma. A separate chapter deals with critical issues in observation medicine based on age, for example, observation medicine for pediatric and geriatric patients. The critical questions addressed in this chapter are:

  1. 1: In adult patients, when compared with inpatient treatment does the provision of observation services, specifically in a dedicated, protocol-driven observation unit (OU), improve patient outcomes, decrease length of stay (LOS), reduce costs, increase patient satisfaction, and have other benefits, including (but not limited to) decreased readmissions?

  2. 2: In adult patients, does the use of OU clinical and administrative methodology (by aggressive early diagnostic and therapeutic management using tools such as protocol-driven therapy) produce equivalent or better results (e.g., patient outcomes, LOS, costs, and adverse events) compared with routine inpatient care?

  3. 3: In the adult emergency department (ED), does use of an OU improve key measures of department efficiency, such as decreases in ED LOS, door-to-doctor time, ambulance diversion, and the left-without-being-seen rate?

Type
Chapter
Information
Observation Medicine
Principles and Protocols
 , pp. 430 - 477
Publisher: Cambridge University Press
Print publication year: 2017

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