New Clinical Decision Unit Benefits Patients, Doctors and Hospital
Robert Takla, M.D., F.A.C.E.P.
Vice Chief, St. John Hospital and Medical Center Emergency Department

Emergency medicine physicians of St. John Hospital and Medical Center will expand their scope of practice to include medical management of patients in observation status throughout the hospital. The new Clinical Decision Unit (CDU) will begin operation in early September 2008 under the leadership of Dr. Margarita Pena.

Emergency medicine physicians are the natural selection to operate such a unit, and I am excited to be part of the solution,” says Dr. Pena. “We are in the hospital; we know what is essential and what can be performed on an outpatient basis. Moreover, we can partner with the primary care physician and the hospital to help care for patients in a quick and safe environment.”

This unit is basically an extension of the emergency center. If it is unclear if a patient needs to be admitted, but is not quite ready to go home, the CDU will be able to help make those critical decisions by carefully treating and monitoring the patient for an extended period of time. Clinical pathways and guidelines will help standardize the care. A few examples of patients most likely to benefit are: asthmatics who may need a few more hours of treatment and observation, chest pain patients who need another set of cardiac enzymes and a stress test, and mildly dehydrated patients who need some IV hydration over the next 12 hours.

The net effects of partnering with the primary care physician and the hospital:

1. The patient – has a shorter and happier length of stay, gets the essential tests done in as quickly a time frame as possible, and the ED physician can handle any emergent situation that may arise.
2. The Private Doctor – will be able to participate in the care and management of their patients when they can, yet be reassured that the ED physician will be there to also manage the care and refer the patient back to their office for follow up.
3. The Hospital – will benefit from improved utilization of resources, better throughput and operational efficiency, and happier patients and primary care physicians.
   
   All in all, the CDU is a win-win for everyone!
   
   
   

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