In 2011, what was the average census of observation patients in the hospital? What was the average census of admitted patients in the hospital? Using the 2011 patient flows, how large should the ED observation unit be to achieve a target utilization of 80%?In 2011, what was the profit flow in dollars/day resulting from patients who entered the hospital (on either observation or admitted status) through the ED?
For the exclusive use of A. Smith, 2019.case W91C33September 16, 2013Middletown General Hospital Emergency Department Observation Unit Analysis ExerciseDr. Nate Greene, director of the Middletown General Emergency Department (ED), looked out over the patients on mobile beds lined up in the hallway. He could barely meet their eyes, understanding fully how upsetting a lack of privacy and impressions of substandard care are to vulnerable people in need. Unfortunately, overcrowding in the ED was commonplace due to a scarcity of inpatient beds in the main hospital. There was no place for these patients to go until an inpatient bed opened up.“There has to be a better way to manage this, at least for the sickest patients,” he muttered to himself. Greene knew that day the ED had already moved 10 patients into the hospital on observation status, and he wished he could call those back and send some of his sickest patients upstairs instead. “If I had a safe place to hold observation patients down here in the ED, it would make a world of difference,” he thought.Middletown General Hospital is a tertiary care hospital with 400 inpatient beds. In 2011, the Middletown Hospital Emergency Department (ED) saw about 200 patients each day. On average, 150 were discharged after being seen, but about 50 stayed overnight. About 20% of these patients were on “observation” status, meaning that an admission decision had not been made, pending test results or the results of an overnight observation stay. The remaining 80% were admitted directly. All patients who stayed overnight (whether admitted or on observation status) were put into an inpatient bed. That is, there was no separate observation area. The average admitted patient stayed 5.8 days and represented about $3,500 in profits to the hospital. The average patient under observation occupying an inpatient bed netted the hospital about $3,300 in profits.Observation patients stayed on observation status for an…