title: Constant observation practices in the general hospital setting: a national survey.
abstract: The authors conducted a national survey of 355 general medical/surgical hospitals to assess constant observation (CO) practices. The authors assessed overall use, expense, staffing patterns, funding strategies, and cost-saving interventions. Virtually all responding hospitals (N = 102) reported using some form of CO. Several hospitals reported significant decreases in CO expenditures after the implementation of cost-saving interventions (the largest annual decrease reported was $340,000). Cost-saving interventions included utilizing consolidated bed spaces, relocating patients near nursing stations, placing at-risk patients in bed enclosure devices, and regularly assisting patients to the toilet. In addition, less costly personnel were hired, and volunteers and/or patient family members provided CO (or were required to assist with the cost of CO). Finally, hospital staff were educated about the costs and the appropriate use of CO. They were also taught to recognize and effectively treat delirium.
authors.affiliation: Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock 72205, USA. WorleyLindaL@exchange.uams.edu
authors.forename: L L
authors.initials: LL
authors.lastname: Worley
authors.forename: E J
authors.initials: EJ
authors.lastname: Kunkel
authors.forename: D F
authors.initials: DF
authors.lastname: Gitlin
authors.forename: L A
authors.initials: LA
authors.lastname: Menefee
authors.forename: G
authors.initials: G
authors.lastname: Conway
mesh_terms: D017046:Cost Savings / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D006769:Hospitals, General; D006801:Humans; D019965:Neurocognitive Disorders / Q000191:economics*; D010347:Patient Care Planning / Q000191:economics*; D010348:Patient Care Team / Q000191:economics*; D011567:Psychiatric Department, Hospital / Q000191:economics; D012449:Safety / Q000191:economics*; D014481:United States