Emergency Department Observation Units: Has the Time Come?
Background: Economic pressures for efficiency in health care have led to the need for new strategies for the care of patients with acute chest pain. Methods: Chest pain observation units have been developed in many hospitals and are widely considered to have the potential to provide rapid and safe evaluations for low-risk patients with acute chest pain. Critical pathways are also an increasingly used strategy for the management of this patient population. Results: Available data suggest that chest pain observation units can decrease 6 month resource utilization compared with patients admitted to traditional sites of care. However, the potential exists for these units to increase resource utilization by encouraging admissions to the hospital of patients who otherwise would have been discharged directly home. Conclusions: Chest pain observation units appear to be an important innovation for the care of patients with a low risk for acute myocardial infarction. Use of guidelines for the se units may permit true increases in efficiency without compromising quality.
Lee
TH
Partners Community Health Care, Inc., Section for Clinical Epidemiology, Division of General Medicine and the Cardiovascular Division, Boston, Massachusetts and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts and Harvard Medical School, Boston, Massachusetts.