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  1. Gabele, Danielle MSN, RN
  2. Bugais, Charlene MS, RN
  3. Laguna, Joanne MSN, RN


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.


CONCLUSION: Inclusion criteria, a rounding checklist, and engagement of MOU and ED nurses helped the MOU and ED with patient throughput.