title: Implementation of a hospitalist-run observation unit and impact on length of stay (LOS): a brief report.
abstract: BACKGROUND
  While the impact of hospitalists on length of stay (LOS) for inpatient medicine services has been studied, there has been little work on the impact of hospitalist involvement in short-stay or observation units.
  
  
  OBJECTIVE
  The primary objective was to examine the impact of a hospitalist-run observation unit on LOS. The secondary objective was to assess utilization of the unit through examining case-weight and LOS.
  
  
  METHODS
  Retrospective cohort study with a preimplementation/postimplementation analysis.
  
  
  METHODS
  University Hospital, the 604-bed teaching hospital for Bexar County, San Antonio, Texas.
  
  
  METHODS
  All patients discharged from the inpatient medicine and observation units with diagnoses of chest pain, asthma, syncope, cellulitis, and pyelonephritis.
  
  
  METHODS
  Creation of a hospitalist-run, nonteaching, 10-bed "Clinical Decision Unit" (CDU).
  
  
  METHODS
  The overall LOS of the "top 5" most common diagnoses was compared for the 12 months preimplementation and postimplementation of the unit.
  
  
  RESULTS
  The overall LOS for all patients decreased from 2.4 to 2.2 days (P = 0.05) between the 12 months preimplementation and postimplementation. The greatest decreases were seen for cellulitis (2.4-1.9 days; P < 0.001) and asthma (2.2-1.2 days; P < 0.001).
  
  
  CONCLUSIONS
  Implementation of a hospitalist-run observation unit was associated with a significantly decreased LOS for all patients regardless of location, suggesting that the unit has led to more efficient care.
authors: South Texas Veterans' Health Care System, University of Texas Health Science Center at San Antonio, Department of Medicine, Division of Hospital Medicine, 7703 Floyd Curl Drive, Room 5.070R Dental, San Antonio, TX 78229-3900, USA. Leykum@uthscsa.edu
authors: Luci K
authors: LK
authors: Leykum
authors: Vincent
authors: V
authors: Huerta
authors: Eric
authors: E
authors: Mortensen
mesh_terms: D001249:Asthma; D002637:Chest Pain; D015331:Cohort Studies; D020445:Hospitalists; D006785:Hospitals, University; D006801:Humans; D038801:International Classification of Diseases; D007902:Length of Stay; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D016730:Program Development; D012189:Retrospective Studies; D013781:Texas; D057832:Watchful Waiting