Constant Observation Practices in the General Hospital Setting: A National Survey

The authors conducted a national survey of 355 general medical/surgical hospitals to assess constant observation (CO) practices. The authors assessed overall use, expense, staffing patterns, funding strategies, and cost-saving interventions. Virtually all responding hospitals (N = 102) reported usin...

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Bibliographic Details
Published in:Psychosomatics (Washington, D.C.) D.C.), 2000-07, Vol.41 (4), p.301-310
Main Authors: Worley, Linda L.M., Kunkel, Elisabeth J.S., Gitlin, David F., Menefee, Lynette A., Conway, Gregory
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cost Savings - statistics & numerical data
Hospital Costs - statistics & numerical data
Hospitals, General
Humans
Medical sciences
Mental health
Neurocognitive Disorders - economics
Organization of mental health. Health systems
Patient Care Planning - economics
Patient Care Team - economics
Psychiatric Department, Hospital - economics
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Safety - economics
Social psychiatry. Ethnopsychiatry
United States
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Summary:The authors conducted a national survey of 355 general medical/surgical hospitals to assess constant observation (CO) practices. The authors assessed overall use, expense, staffing patterns, funding strategies, and cost-saving interventions. Virtually all responding hospitals (N = 102) reported using some form of CO. Several hospitals reported significant decreases in CO expenditures after the implementation of cost-saving interventions (the largest annual decrease reported was $340,000). Cost-saving interventions included utilizing consolidated bed spaces, relocating patients near nursing stations, placing at-risk patients in bed enclosure devices, and regularly assisting patients to the toilet. In addition, less costly personnel were hired, and volunteers and/or patient family members provided CO (or were required to assist with the cost of CO). Finally, hospital staff were educated about the costs and the appropriate use of CO. They were also taught to recognize and effectively treat delirium.
ISSN:0033-3182
1545-7206
DOI:10.1176/appi.psy.41.4.301