Observation Ward
OVERVIEW
- Observation ward is a short stay ward
- Integral part of the emergency department
- Staffed by the emergency department
- Has defined admission and discharge criteria
- Admission of specific diagnostic related groups
- Has a focused multidisciplinary approach
DIAGNOSES APPROPRIATE FOR OBS WARD
Specific diagnosis related groups examples
- Minor head injury
- Drug overdose
- Intoxication
- Renal colic
- mild-moderate pyelonephritis
- musculoskeletal low back pain
- elderly patients not suitable for discharge at night, but no other barriers to discharge
ADVANTAGES FOR THE HOSPITAL
- Shorter admission time for specific DRGs
- Thus cost savings and decreased average length of stay
- Acts as as a safety net
- Decreased incorrect discharge and thus decreased litigation
ADVANTAGES FOR THE ED
- Streamed lined treatment pathway
- Decompression of ED
- Assessment for intoxicated patients
ADVANTAGES FOR THE PATIENT
- Access to experts in DSH and Psychiatry
- Crisis intervention
- Prevents inappropriate discharge for example elderly late at night
DIASADVANTAGES
- Fragmentation of care of patients who will require admission
- Inappropriate admission
- Problematic discharge, d/c with inadequate assessment and community social support
- Resources for ED diverted
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC