A place for observation

New Clinical Decision Unit at MCR aims to open up inpatient capacity
January 20th, 2016

For patients needing a little extra time to recover, Medical Center of the Rockies (MCR) has just the spot.

The seven-bed Clinical Decision Unit (CDU) on MCR’s first floor is designated exclusively for patients who don’t need inpatient-level medical care, but are not quite ready to go home. The CDU provides them with the specialized care they need to prepare for a smooth discharge, said Tamara Varner, nurse manager for both the CDU and MCR’s cardiac unit.

The new unit opened Jan. 4.

“The CDU provides care to patients designated as observation status, extended recovery, and post-procedural monitoring,” Varner said. “I am excited that our organization provides a designated unit for these patients at MCR.”

While an observation patient in the CDU does not qualify for longer than a one-day stay (based on the physician’s admitting diagnosis and inclusion/exclusion guidelines) patients may still require close observation before they’re ready to be discharged, Varner explained. Similarly, patients recovering after certain outpatient-based surgical procedures may need only a few extra hours of monitoring. The CDU is designed to fit these types of needs, she said.

CDU patients come from ortho/spine, trauma/surgical, medical, and cardiac units; the cardiac catheterization lab (where outpatient cardiac procedures are performed); direct admits; and the emergency department, according to Jake Mentele, UCHealth administrative fellow and the CDU’s project manager. And, he added, the benefits of having a dedicated unit for short-term observation will benefit the hospital and patients alike.

“It opens up our capacity, especially when we have a high census, so we can use inpatient beds for those patients at higher acuity,” Mentele said. “In the long run, we will end up treating more people in the community.”

Emily Young, RN, enjoys a laugh with cardiac patient Rex Kellums in the new Clinical Decision Unit at Medical Center of the Rockies. Photo by Kati Blocker, UCHealth.

Recent changes in health care have mandated that the Centers for Medicare and Medicaid Services determine hospital charges primarily based on two things: a patient’s diagnosis and how quickly the condition improves. This makes it crucial to accurately and expediently determine what is wrong, while also sending people home sooner.

For example, life-threatening conditions such as blood infections or heart attacks often require a number of costly and time-intensive resources to diagnose and treat. As such, high-acuity patients are best cared for in an inpatient unit. But some patients arrive at the hospital with conditions that may warrant only a few diagnostic tests, less complex medical interventions and assistance with discharge planning. The CDU is ideal for these patients.

The CDU, open 7 a.m. to 7 p.m. Monday through Saturday, is specifically geared toward providing care in an observation setting, Varner said.

“A nurse on an inpatient unit cares for multiple patients with a range of conditions with the same high level of concern and care,” she said. “Nurses on the CDU are working round the clock on discharge even before they get the discharge order, so when they get it the patient can go.”

Considerable interdisciplinary collaboration went into preparing the CDU for opening, Varner said. This included months of strategic planning, training on various inpatient units, as well as trips to UCHealth Metro Denver to research processes and expose staff to disaster training and emergency simulations. Varner is confident that these measures will contribute to lowering the average patient length of stay and 30-day readmission rates.

For Robin Reed, a nurse on the CDU, the unit’s opening means improving health care across the continuum.

“We have the potential to see a wide variety of patients on their health care journey,” Reed said. “I look forward to growing and nurturing this new and innovative unit.”

About the author

Andrew Kensley has worked as a freelance writer in northern Colorado since 2009. In addition to his work for UCHealth, he is a regular contributor of essays, features and the News & Notes section of Fort Collins Magazine. He also has written numerous cover profiles, Q&As, and travel and wellness features for Mind+Body Magazine and the Fort Collins Coloradoan, the newspaper in which his parenting column, “Wee Wisdom,” ran Sundays from 2009 to 2013. His travel essays have been featured in the family travel website, Momaboard.com.  

Andrew published his first novel, “Seeking Blue,” in 2014, and his short fiction has appeared in the University of Wyoming’s literary journal, Owen Wister Review.

Andrew was born in Montreal, Canada, and has lived in Fort Collins since 2004. A 1996 graduate of McGill University, he continues to work as a physical therapist, helping people regain their mobility, confidence, and functional abilities. He speaks French, Spanish and Hebrew, and loves to travel.