Implementation of a hospitalist-run observation unit and impact on length of stay (LOS): A brief report

Luci K. Leykum, Vincent Huerta, Eric Mortensen

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


BACKGROUND:: While the impact of hospitalists on length of stay (LOS) for inpatient medicine services has been studied, there has been little work on the impact of hospitalist involvement in short-stay or observation units. OBJECTIVE: The primary objective was to examine the impact of a hospitalist-run observation unit on LOS. The secondary objective was to assess utilization of the unit through examining case-weight and LOS. DESIGN: Retrospective cohort study with a preimplementation/postimplementation analysis. SETTING:: University Hospital, the 604-bed teaching hospital for Bexar County, San Antonio, Texas. PATIENTS: All patients discharged from the inpatient medicine and observation units with diagnoses of chest pain, asthma, syncope, cellulitis, and pyelonephritis. INTERVENTION: Creation of a hospitalist-run, nonteaching, 10-bed "Clinical Decision Unit" (CDU). MEASUREMENTS: The overall LOS of the "top 5" most common diagnoses was compared for the 12 months preimplementation and postimplementation of the unit. RESULTS:: The overall LOS for all patients decreased from 2.4 to 2.2 days (P = 0.05) between the 12 months preimplementation and postimplementation. The greatest decreases were seen for cellulitis (2.4-1.9 days; P < 0.001) and asthma (2.2-1.2 days; P < 0.001). CONCLUSIONS:: Implementation of a hospitalist-run observation unit was associated with a significantly decreased LOS for all patients regardless of location, suggesting that the unit has led to more efficient care.

Original languageEnglish (US)
Pages (from-to)E2-E5
JournalJournal of hospital medicine
Issue number9
StatePublished - Nov 1 2010


  • Asthma
  • Chest pain
  • Clinical
  • Outcomes measurement

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis


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