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University Medical Center in Tucson, Ariz., will increase capacity dramatically in an expansion slated for 2008, but relief from crowded conditions should arrive even sooner. Early next year, UMC will open a 16-bed short-stay unit.

“We are at maximum capacity, and there are times we have to turn away referrals from other hospitals because we have no beds,” says Eileen Whalen, UMC’s vice president for trauma, emergency and perioperative services. “This is affordable, and we can get it up in the time frame we need.”

Those magic attributes—affordability and timeliness—combine to make short-stay units an increasingly popular solution to the capacity crisis at hospitals across the country.

Sometimes called “critical decision units” or “clinical decision units,” the short-stay unit reflects both the evolution of healthcare and the ingenuity of healthcare executives. As emergency room volumes steadily rise and procedures move to outpatient status, the short-stay option allows hospitals to handle more volume in their emergency departments and outpatient-procedure units. Likewise, the short-stay unit prevents inpatient beds from being occupied by patients who don’t need them.

Shawnee Mission Medical Center in Merriam, Kan., created a 24-bed short-stay unit in 2005 after an assessment of capacity constraints and delays in admitting patients to a medical floor. “One of the things that stood out was the number of outpatients in our inpatient environment,” says Sheri Hawkins, vice president and chief nursing officer.

No more. The short-stay unit, designed for patients who will stay 23 hours or less, sees a broad mix of patients: ambulatory procedure patients, infusion patients and emergency patients who need to be observed before a decision is made about admission.

Kadlec Medical Center in Richland, Wash., opened a short-stay unit in 2001 to alleviate inpatient capacity problems. The unit’s 12 beds get a lot of sheet changes.

“We see somewhere around 40 patients a day—sometimes it’s higher,” says Suzanne Richins, the hospital’s chief operating officer. “Sometimes you have patients there just an hour or two.”

The unit has helped boost revenues because procedure departments can accommodate more patients. “We don’t have to cap surgery or cap cath lab patients,” Richins says. “They can do as many as they need to do because we can handle the follow-up care.”

Indeed, the unit has been so successful that an expansion, slated for completion in 2008, will add a second, 38-bed short-stay unit.

In most cases, the cost of creating a short-stay unit is lower than a standard inpatient space. For example, the Kadlec short-stay rooms do not have private bathrooms. Likewise, at Tucson’s UMC, a short-stay room will be designed for, well, a short stay.

“The rooms are larger than a recovery area, but smaller than an inpatient room,” Whalen says.

—Lola Butcher




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