Despite its state-of-the-art capabilities and new construction, no one wants to include a trip to Utah Valley Hospital’s emergency room in their daily goals.
However, 136.9 million visits are made to emergency departments every year in the United States (Provo’s showpiece hospital included), according to the National Hospital Ambulatory Medical Care Survey and referenced by the CDC.
Out of those visits, only 9 percent (about 12.3 million) result in hospital admission.
Due to high volume and overcrowding, only 35.4 percent of emergency department patients are seen in less than 15 minutes.
To fight national trends, Utah Valley Hospital has added a Clinical Evaluation Unit (CEU) to work with patients who receive treatment in the emergency room, but require further observation in a less-urgent setting.
“There is a certain group of patients, having received treatment in the emergency department, who are too sick to return home, but not sick enough for an extended inpatient stay,” says Dr. Michael Osborn, medical director of the CEU. “Additionally, there are patients whose emergency department care has them in a stable condition, but further testing or immediate extended (8-24 hours) treatment is still required before it is medically appropriate to send them home. The Clinical Evaluation Unit is a new 20-bed unit at Utah Valley Hospital adjacent to the emergency department designed and dedicated to providing compassionate, comfortable care for these patients.”
Offering the best of both worlds
The CEU takes the best from the inpatient setting and the best of emergency medicine and combines them into a place where patients can receive the care and assessment they need without using emergency department space or the cost involved with an extended hospital admission.
“Healthcare is continuously moving closer to an outpatient approach to medicine,” says Amy Elmer, practice manager. “This unit will facilitate rapid treatment and planning to get patients the help they need.”
Staff members will navigate to the necessary resources to make sure the patient receives ongoing specialized medical intervention.
It is anticipated based on the experience of other such units around the country that patients will average about 16 hours in the CEU.
The doctor will see you now
While the unit only recently opened and is just beginning to see patients, Dr. Osborn and other staff member anticipate seeing a high volume of patients experiencing chest pain.
“Chest pain is a common reason for patients to present to the emergency department and can have serious, life-threatening causes, including a heart attack,” he says. “In the emergency department, we are able to ensure a patient is not having an active heart attack. But, often chest pain can be a sign of a future heart attack. In the CEU, we are able to provide further monitoring and diagnostic tests to ensure the pain is not from damage to the heart and, in consultation with specialists, develop a plan to reduce the risk of future problems.”
Other common issues that lead to the transitional observation space include asthma and other breathing problems, dehydration, gastrointestinal bleeding, syncope (passing out), mini-strokes, allergic reactions, croup and blood sugar problems.
A collaborative collection
The location of the unit — strategically next to the emergency department and close to helpful diagnostic equipment and services — is telling to the way physicians, physician assistants, nurses and other staff members approach patient care.
“We have access to all of the diagnostic capabilities within the hospital, including laboratory and radiographic tests,” Dr. Osborn says. “Chest pain patients will be able to rapidly receive a cardiac stress test. TIA (mini-stroke) patients will be able to receive an MRI of their brain and an ultrasound or ECHO of their heart.”
Additionally, each room is equipped with heart monitors and telecommunications equipment that expedites consultation with specialists.
Dedicated to best possible outcomes
The CEU is dedicated to its patients leaving and living the healthiest lives possible. It takes seriously its obligation to match patients with the additional services and medical advice they need in an environment of respect and inclusion.
“This unit gives patients the quicker, more efficient and cost-effective care they have been asking for,” Amy says. “The staff can still give safe and high-quality care, even though it is a shorter time than an inpatient stay. And once the patient is ready for discharge, the CEU is committed to getting patients the available community resources they need.”
With the unit being overseen by board-certified emergency physicians, patients receive close medical attention, 24 hours a day, seven days a week.
“The physicians caring for patients in the CEU are all board-certified emergency medicine physicians,” Dr. Osborn says. “In the emergency department, we focus on providing treatment with rapid reevaluation. Having an emergency medicine team means patients will have access to a provider 24/7 — meaning they don’t have to wait until traditional once-a-day rounding times to get results of their tests and procedures. This also means we are readily available if a patient’s condition worsens or if an unexpected need were to arise.”
It also means there will be less stress on the often overworked emergency department and more efficient treatment of patients.