title: Medical Observation Units and Emergency Department Collaboration: Improving Patient Throughput.
abstract: OBJECTIVE
  The aim of this study was to identify whether observation status patients placed in a dedicated unit would decompress the emergency department (ED) more than observation patients who were admitted to other available beds.
  
  
  BACKGROUND
  An urban quaternary hospital has a high volume of patients with average daily census of 95% capacity. A medical observation unit (MOU) was created to improve patient throughput.
  
  
  METHODS
  In phase 1, the MOU charge nurse reviewed the ED patients to be admitted and selected appropriate patients based on unit inclusion criteria. In phase 2, the MOU charge nurse did rounds with the ED charge nurse once per shift.
  
  
  RESULTS
  MOU observation patients demonstrated a 53-minute (16%) reduction in average overall ED length of stay compared with observation patients admitted to other units.
  
  
  CONCLUSIONS
  Inclusion criteria, a rounding checklist, and engagement of MOU and ED nurses helped the MOU and ED with patient throughput.
authors.affiliation: Authors Affiliations: Nurse Manager (Ms Gabele), Nursing Resources Clinical Nurse Specialist (Ms Bugais), Director of Nursing Resources (Ms Laguna), Cedars Sinai Medical Center, Los Angeles, California.
authors.forename: Danielle
authors.initials: D
authors.lastname: Gabele
authors.forename: Charlene
authors.initials: C
authors.lastname: Bugais
authors.forename: Joanne
authors.initials: J
authors.lastname: Laguna
mesh_terms: D003299:Cooperative Behavior; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006757:Hospital Units / Q000458:organization & administration*; D006786:Hospitals, Urban; D019370:Observation