Date of Award

Fall 2022

Document Type


Degree Name

Master of Science in Nursing (MSN)

Committee Chair

Erin Montgomery


An acute care observation unit provides care for patients admitted via Emergency Center (EC) or direct admission from a healthcare provider’s office who do not yet require inpatient status. The goal length of stay (LOS) for these patients should be less than or equal to 24-48 hours. This project is being developed for a 22-bed observation unit in the Southeastern United States to decrease current LOS hours. Currently, the goal LOS for this unit is 24 hours, not to exceed 48 hours, and for patients admitted with a chest pain diagnosis, no longer than 19 hours. A plan to expand current exclusion criteria will involve excluding the geriatric population over 80 years of age and patients with post-hospitalization placement issues from observation status. Expanded exclusion criteria will decrease LOS within the unit by increasing appropriate observation admissions. In addition, an after-hours discharge procedure will be implemented to allow for discharges after 1900 each day. This project will be conducted over a 6-month trial period. Post completion of the 6-week trial period, monthly LOS hours, revenue, and patient satisfaction scores will be compared to the previous year. It is hypothesized that by expanding exclusion criteria and implementing the after-hours discharge process, LOS hours will decrease, and patient satisfaction will increase.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License