Observation medicine encompasses the management of selected patients for a timeframe of 6 to 24 hours to assess their need for inpatient admission. This service is best provided in a dedicated observation unit, ideally in the Emergency Department. Relative to traditional admission, studies have shown this alternative to have several beneficial health care outcomes:
- Improved patient satisfaction
- Lower health care costs
- Shorter length of stays
- Improved use of hospital resources
- Less diagnostic uncertainty
The Emory Observation Medicine program is nationally recognized for contributions to the clinical practice of observation medicine, national health care policy, education, and research. Emory’s observation units have been used as benchmark best-practice models in reports from the:
- Institute of Medicine
- Health Care Advisory Board
- American College of Emergency Physicians
- Center for Medicare and Medicaid Services
At our Emory-affiliated hospitals, we provide high-quality, accelerated, protocol-driven care to selected emergency department patients. Observation services are provided in a pleasant setting by Emergency Department faculty and staff. Each of our primary hospitals has an observation unit called a Clinical Decision Unit. These are nationally recognized benchmarks in this field.
Commonly observed conditions include patients with:
- Chest pain
- Asthma
- Congestive heart failure
- Infections
- Syncope
- Transient ischemic attack
Patient care guidelines and protocols are developed through a combination of evidence-based medicine and expert consensus with other respective specialties involved in the care of each condition. This allows care to be standardized to a “best practice” in a way that can be closely monitored.
Quality
Emory University Hospital and Emory University Hospital Midtown are accredited Chest Pain Centers at the highest level standard, “accredited with PCI.” From the perspective of quality and safety, based on evidence and best practices, this has standardized the care of patients with chest pain, myocardial infarction, and acute coronary syndromes. In addition, the process of attaining and maintaining accreditation ties directly into the Emory Healthcare goals of Care Transformation, and has led to a wonderful interdisciplinary collaboration among several departments – Emergency Medicine, Cardiology, Hospital Medicine, Clinical Pathology, and Nuclear Medicine, to name a few. This hospital-wide integration brings Emory toward a common goal – to prevent untimely death and disability due to acute coronary syndromes.
Dr. Ross serves on the steering committee of ACTION Registry Get-with-the-guidelines, a product of NCDR, a division of ACC. This is the premier quality data collection tool for hospital-based care of patients with acute myocardial infarction (STEMI and NSTEMI). Emory faculty from the Departments of Emergency Medicine (Dr. Ross and Dr. Osborne) and Cardiology (Dr. Rab and Dr. Goyal) also participate in the Atlanta regional Mission Lifeline network, a division of the American Heart Association whose goal is to assure that patients suffering heart attacks anywhere will receive the best care at the most qualified hospitals by integration of pre-hospital care (EMS) with hospitals.
Research
Emory Emergency Medicine's Observation Medicine program offers opportunities for residents and fellows to learn research skills by participating in clinical studies and scholarly publications. The Emergency Medicine department has collaborations with nationally recognized leaders in research, observation medicine, and academic emergency medicine.
Specific areas of research opportunity include:
- Cardiovascular disease including cardiac stress testing and imaging
- Neurological diseases, with an emphasis on transient ischemic attack
- Database registries
- Multicenter studies of observation services and chest pain centers, and
- Administrative research
- Tele-observation