March/April | 2010
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Watching and Waiting
Adult Medical Observation Unit frees inpatient beds while offering top-notch care to patients with unclear needs

“The doctor is keeping him overnight for observation.”

That sounds like a line from a movie, but it is an everyday reality here at the Health System where in Fiscal Year 09 we logged in 8,628 observation cases. Our most recent addition to observation care is the new Adult Medical Observation Unit, which opened near the Emergency Department last July. The AMOU is open 24 hours a day, seven days a week. UMHS also has a Surgical Observation Unit and a CVC Observation Unit.

The Adult Medical Observation Unit allows for active observation of patients who are too sick to go home, but may not need to be admitted.“We excel at taking care of patients who may have an unpredictable medical problem or an unforeseeable course ahead of them,” says Jason J. Ham, M.D., AMOU director and assistant professor of Emergency Medicine and Internal Medicine.

The new unit treats patients who are too sick to go home but don’t need to be admitted. Most patients come from the Emergency Department. Only 11 percent of AMOU patients eventually need to be admitted to an inpatient bed, freeing up licensed beds for patients who need them. AMOU patients are considered outpatients and stay an average of one day.

“Our whole focus is getting patients adequately prepared to go home while giving world-class care,” says Ann Kohler-Kaiser, MSA, BSN, R.N., nurse manager.

Ham notes, “These are patients whom we are actively observing, we don’t hold someone just for a consultation or tests. We have the staff and the intensity to respond very quickly. We care for many patient types, from unpredictable ED observations to post-procedural observations with risk for complications.”

During the planning process, AMOU staff involved people from across different units to give input, designed the unit to be comforting and pleasing to the eye, used lean principles, and developed clear customer service goals.

The whole team cites Patient Food and Nutrition Services, Environmental Services, Materiel Services and many other units for their feedback, cooperation and encouragement. Eileen Callaghan, R.N., clinical nurse supervisor, says, “PFANS, for example, has been a huge help when some of our patients need to transition their diets as they get well enough to go home.”

Staff also are excited about the unit’s new case manager position, which monitors the overall usage of the unit, plans for patient discharges and provides patients with social work services. These are all necessary components of today’s health care environment and make it easy for patients to navigate their stay. 

Kohler-Kaiser says, “The response from patients to the new AMOU pleases us to no end.”

Written by Cathy Mellett

For more information about the unit, contact Dr. Ham or Ann Kohler-Kaiser at 734-232-2867 or 800-962-3555.

To refer a patient, please contact the Admissions and Bed Coordination Center.

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