Currently, one in every two patients bedded from the Houston Methodist Sugar Land Hospital ED is placed in observation status, resulting in HMSL having the highest observation bedded percentage in the system (52 percent). Keeping Medicare patients in observation status when there is a reasonable expectation that they will require at least a two-midnight stay can result in exorbitant costs to patients and families.
In response to this issue, our ED, Hospitalist and Case Management leadership teams are collaborating to design a new patient statusing process in the ED to support our ED physicians. This process includes the addition of a dedicated utilization review (UR) nurse in the ED to assist with appropriate statusing. Adding a UR nurse in the ED will allow our ED physicians to focus on patient care and triage. Once the ED physician decides the patient needs to be admitted, the UR nurse applies their expertise and focus to determine the appropriate status – inpatient or observation.
This new process is tentatively scheduled to launch the first week in March. Details regarding this process will be shared at key physician and staff meetings prior to launch. This is one of many processes we’re collaborating on at HMSL to deliver unparalleled care to our patients.