MOUNT VERNON — On Monday, Knox Community Hospital implemented a new patient classification system which, KCH officials hope, will reduce the amount of time some patients spend waiting in the emergency room.
According to Prema Samhat, director of marketing/community relations, the emergency room is the first stop for many patients going to the hospital for health care. It’s in the ER that lab work or imaging tests are sometimes ordered to see if the patient needs to be admitted for a hospital stay, or if they can be treated as an outpatient and sent home.
Sometimes the patient’s symptoms and test results indicate a period of monitoring, and perhaps further testing, is needed before a decision to admit or discharge the patient is made, Samhat said. That is where the new Clinical Decision Unit comes in.
After the initial emergency room evaluation, the staff will consider if there is a need for further diagnostic and imaging studies to help determine a diagnosis. Patients with conditions such as low risk chest pain, passing out, dehydration, low or high blood sugar levels, migraines or kidney stones may be transferred to the CDU for further observation, testing and/or treatment by their primary care physician or hospital staff doctor.
The CDU process, said Sandy Beidelschies, vice president of patient care service, should help reduce the stress of the patient.
“They will be more comfortable [in the CDU],” she explained. “They will be in a bed where they can access the phone, restroom, television. They can have visitors. We think it’s actually better customer service for our patients. It’s not a whole lot different from what we were doing [before], it’s just how we’re doing it.”
For example, Beidelschies said, a blood test done in the emergency room might indicate that something might be going on, but the timing for the follow-up test might not be for a couple of hours. Previously, the patient would wait in the emergency department until those couple of hours passed before further tests could be done.
“With the CDU,” she explained, “the patient can get out of the emergency department and wait, if you will, on the floor. They are in a patient room. To the patient it might look like they have been admitted to the hospital, but they have not. They’re inside the hospital in a bed, but their status is CDU patient. That means we are still making clinical decisions about this patient as to whether they could go home and maybe be treated as an outpatient, or whether they need to be admitted because their condition is getting worse. ... It’s an opportunity to give us a chance to do more diagnostic testing or clinical data collection to make a decision as to what’s going on with this patient.
“We think the patients will like it,” said Beidelschies, “because we’re doing this intense workup that will hopefully give them an answer. If you are admitted to the hospital from CDU, it should decrease the amount of time that you’re in the hospital, because we’ve already done a lot of that workup and have a better idea of what’s going on. ... We just think we will get better patient outcomes.”
Samhat said national data show that about 20 percent of CDU patients eventually become inpatients. The majority can expect to be treated and sent home within 16 to 18 hours.