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Temporary Clinical Decision Unit at John Muir Medical Centre

Rationale / Objectives

John Muir Medical Centre wanted to reduce overcrowding in the emergency department by implementing a temporary clinical decision unit while a permanent CDU was under construction.

Project/Program Description & Major Achievements

John Muir Medical Center is a 324-bed nonprofit hospital in California. The hospital constructed a Clinical Decision Unit (CDU) for patients being monitored on a non-emergent basis. In order to reduce Emergency Department boarding and its drain on inpatient beds, a temporary clinical decision unit was implemented. CDU data results reported to have improved patient flow, reduced ED hold times, increased capacity of available inpatient beds and the elimination of ambulance diversion to the ED.

 

Lessons Learned

In a space constrained ED with no capital improvement business case, non-traditional thinking about temporary space can provide creative clinical decision unit solutions.

Further Description

John Muir Medical Center is a 324-bed nonprofit hospital in California. The hospital planned to construct a Clinical Decision Unit (CDU) for patients being monitored on a non-emergent basis. The new space would reduce overcrowding in the emergency department. It also aimed to develop a temporary Clinical Decision Unit while the new tower with a permanent CDU was under construction. John Muir Medical Center found that CDUs have similar design profiles to mobile surgical units. They adapted a mobile surgical unit from Mobile Medical International Corporation and set up a temporary CDU with seven beds in the emergency department's parking lot. The challenge of physical space is always a key issue when a capacity-driven hospital is attempting to add a new product line.

John Muir wanted a temporary solution and came up with a creative solution, not limited to traditional ways of thinking about new space by adapting a mobile surgical unit.

Major Achievements

The temporary CDU opened in September 2004.  It was to be used for the next three-five years while a permanent CDU was constructed. Specific metrics listed below were reported to have improved (specific results not available). John Muir Medical Center expects to see a dramatic reduction in ED hold times, reduced use of in-patient beds from ED patients that qualify for the CDU, and an increase in capacity of inpatient beds that will be available for other patients.

Metric Result Detail
Open a temporary, fully functional CDU  Complete  Opened Sept. 2004
Reduce ED hold times Improved *specific rates not available
Increase availability of inpatient beds Improved *specific rates not available
 Ambulance diversion to ED Eliminated