Providence Health Care is one of the first Emergency Departments (ED) to implement a Diagnostic Treatment Unit (DTU), which takes patients and their family members away from the activity in the ED to a quasi-inpatient ward atmosphere, which is a better experience for patients. Some ED patients require aggressive therapy and/or monitoring to determine whether they require admission to hospital. At the end of this observation and treatment period (up to 24 hours), 85 percent are well enough to be discharged. If they are eventually admitted after observation, they experience shorter hospital stays. The ability to discharge these patients without actual admission does several things: 1) it prevents admission to the inpatient wards, which saves money and resources; 2) it allows patients to leave the ED sooner, improving overall throughput in the ED; and 3) it improves patient satisfaction and safety. The DTU is a quiet area that is well staffed by RNs and a Nurse Practitioner. Standards and protocols are in place to improve flow. The DTU has four beds located outside (but in close proximity to) the main acute care area of the ED. There is a favorable 4:1 nursing ratio in the unit and patients receive much closer observation that they would in the ED where new, sick patients occupy the nurses’ time or on the ward, where there are many other patients who need care.
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