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Observation Medicine
  • Principles and Protocols
  • 2nd edition
  • Edited by Sharon E. Mace
  • Coming soon
  • Expected online publication date:
    December 2024
    Print publication:
    31 December 2024
  • Using comprehensive sample administrative and clinical protocols, this fully updated and practical second edition guide to observation medicine (OM) provides a detailed account of how to establish and run an observation unit (OU) and reviews medical/surgical/obstetrical-gynecologic/psychiatric/social conditions in which OM may be applicable. The book covers clinical topics including improving patient outcomes, avoiding readmissions, and using OM in a pandemic or disaster. Practical topics on design, staffing, and daily operations; fiscal and business aspects, such as coding, billing, and reimbursement; regulatory concerns such as aligning case management and utilization review with observation; nursing considerations are all present. The new edition features many new chapters and topics ranging from the geriatric OU, psychiatric observation, telemedicine in OM, to the cancer patient in the OU. Applicable to an international audience, it offers instructions for implementing observation in any setting or locale and in any type of hospital or other appropriate facility.

  • Part VII - Evidence Basis for Observation Medicine

  • Edited by Sharon E. Mace
  • Book:
    Observation Medicine
    Published online:
    31 March 2017
    Print publication:
    16 March 2017, pp 429-508

  • 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?

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