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Observational Medicine
Observational Medicine
Observation medicine delivers intensive short-term assessment, observation or therapy to optimise the early treatment and discharge of selected emergency patients.
The model is an alternative to extended stays in hospital EDs and/or multiday inpatient beds for short-term care. The observation medicine unit is a ward-like setting usually located near an ED or speciality inpatient ward (for example, medical, paediatric, psychiatric).
Purpose of CDU:
Purpose of CDU:
provide evidence-based, high-quality, intensive short-term observation and treatment
reduce inappropriate admissions to inpatient beds and associated healthcare costs
improve patient flow by providing timely assessments and treatment, allowing patient discharge in the shortest, clinically appropriate time.
Improves Patient Flow
Improves Patient Flow
providing a comprehensive care model specific for patients requiring short-term treatment / observation
reducing avoidable admissions (for example older patients, chest pain)
increasing capacity to manage high ED patient volume
actively seeking appropriate patients (‘pull’) from the ED early in their episode of care
Improves clinical outcome
Improves clinical outcome
early access to short-term specialist services
intensive or short-term care/frequent evaluation of a specific group of ED patients.
evidence-based care pathways (reduce variations in care delivery)
decreased length of stay and decreased multiday hospital admission rates, without increasing the rate of hospitalisation or readmission
greater continuity of care by reducing the number of transitions that can lead to
errors, delay, duplication and lost information
more comfortable than ED
16 CDU Pathways
16 CDU Pathways
Alcohol Intoxication
Lower Limb Cellulitis
Hip Pain
Self Harm
Alcohol Withdrawal
Chest Pain
Observation (A/W results)
Social (OT/PT)
Allergy
Dehydration
Renal Colic
Awaiting for Transport
Back pain - Non-injury
Head Injury
Sedation
UTI
Workflow
Workflow
Patients identified as eligible for CDU admission will be discussed with the senior ED doctor (EDIC) and Nurse in Charge (NIC) first.
When CDU admission is decided, the CDU SHO (Bleep 343) completes the admission documentation and reviews the patient.
CDU team delivers the care as discussed, presents the case on the daily CDU MDT meeting (09:00) and completes the discharge process and discharge summary when appropriate.
CDU MDT meetings
CDU MDT meetings
Every day (Mon-Fri) at 09:00 - 09:30 - in the Staff Room (opposite CDU)
The multi-disciplinary team will review all patients, establish the management and discharge plans, and identify priorities.
Important Bleep Numbers
Important Bleep Numbers
552 - CDU Consultant (0800-1600)
445 - ED Senior SpR (EDIC out of hours)
343 - CDU SHO (24/7)
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