A hospital in Murfreesboro has launched a special unit meant to relieve overcrowding in the emergency room, which has grown busier as Rutherford County’s population booms. It’s a model that’s a middle ground for patients who need to see a doctor quickly but don’t necessarily need to be admitted to the hospital.
A growing number of medical centers are using what’s called a “clinical decision unit.” At Saint Thomas Rutherford, this inhabits a new 25-bed wing off the ER.
“We’ve got mostly chest pain,” says chief medical officer Tim Bode, reading from the status board. “We’ve got somebody who is lightheaded, dizzy and passing out. And then somebody that’s short of breath.”
They’re all fairly typical conditions that arrive in an ER, and there’s a standard battery of testing. But getting a diagnosis takes time. And previously, that has required putting somebody in the hospital to wait on test results and visits from specialists who might be scattered all over the campus.
“Exact same care, but you’re here for two and a half days,” Bode says. “In this unit, we can do that care in 18 hours. That’s just better for everybody.”
The CDU benefits from the round-the-clock schedule in the neighboring ER, a dedicated physician assistant coordinating care for patients, and a heightened sense of urgency to clear the rooms.
Less time in the hospital should result in lower out-of-pocket costs for patients.
“I manage a finance company. Money is on my mind all the time,” says Tim Springer of Murfreesboro, who just spent the night in the CDU after coming in with shortness of breath.
Springer hadn’t heard about this new unit and calls his room “fairly Spartanish” — no toilet of his own, no food service. But he says that’s acceptable if he ends up avoiding the kind of charges that go along with being admitted to the hospital. And he hopes not to stay long.
“I’ve got another breathing treatment coming up in about 20 minutes, so we’ll go from there,” he says.
These CDUs sometimes go by different names — chest pain centers, observation or short-stay units. They
aren’t a straightforward moneymaker for the hospital, which can’t charge as much to see patients classified as outpatient.
But Saint Thomas officials say the unit
pays off in other ways like keeping the ER from overcrowding and making sure the hospital has beds for the sickest patients who really need them.
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