Observation Management — Keys to a Successful ACS Observation Program - 2022 Quality Summit presentation (Non-CE)-Observation Management — Keys to a Successful ACS Observation Program

Video Transcription

Video Summary

In this video, Mary Jane Ayers, the Clinical Director of Cardiac Programs at York Hospital in York, Pennsylvania, discusses initiatives implemented at their hospital to manage the observation length of stay for acute coronary syndrome (ACS) patients. Ayers aims to identify two factors that can reduce the length of stay for these patients, emphasize the importance and cost-effectiveness of observation services, and identify obstacles to achieving a 16-hour ACS observation length of stay goal.<br /><br />Observation patients are those admitted through the emergency department who require further testing and short-term medical treatment before a decision can be made about whether they can be safely discharged or need inpatient admission. The goal for observation status is a minimum of eight hours, with ACS patients ideally being assessed and discharged within 16 hours. The hospital implemented initiatives such as strict inclusion and exclusion criteria for observation patients and addressing barriers to 24/7 discharge, including physician availability and timely ancillary testing.<br /><br />The hospital used their electronic medical record system to identify observation patients and implemented a running clock to track their length of stay. They also developed patient selection screening processes and a checklist-based discharge criteria for nursing to follow. The hospital addressed the operating hours of ancillary departments and focused on extending their hours to accommodate ACS patients. These initiatives have led to a significant improvement in the median length of stay for chest pain observation patients, decreasing it from over 30 hours to 16 hours.<br /><br />The hospital continues to refine their initiatives and monitor turnaround times for testing and imaging. Ayers emphasizes the importance of teamwork and involving all stakeholders, including providers, nursing staff, and ancillary departments, to achieve success in reducing observation length of stay. Ayers encourages viewers to reach out with any questions and wishes them success in their own facilities.

Keywords

ACS patients

observation length of stay

initiatives

electronic medical record system

improvement

teamwork