1:00 pm
Christopher Caspers
Christopher Caspers, MD
Chief, Observation Medicine, NYU Langone Health System;
Associate Professor, NYU School of Medicine;
President-Elect, Observation Medicine Section, American College of Emergency Physicians

1:15 pm

Instead of admitting patients as inpatient, there has been an increasing regulatory trend of nudging patients towards less costly outpatient settings. Observation care in some instances has proven to be an effective alternative to inpatient admissions which not only increases patient satisfaction but also reduces cost. In this panel, discuss the current landscape and future of observation medicine, and hear how hospitals and health systems are optimizing and expanding their observation services.

  • Define observation care and the current patient population served
  • Review regulatory changes and advancements in observation medicine in the past year
  • Examine how consumerism and technology is affecting health care and observation care

Moderator:

Christopher Caspers
Christopher Caspers, MD
Chief, Observation Medicine, NYU Langone Health System;
Associate Professor, NYU School of Medicine;
President-Elect, Observation Medicine Section, American College of Emergency Physicians

Panelists:

Dean Harrison
Dean Harrison, MPAS, PAC, DFAAPA
Director, Clinical Evaluation Unit; Director, Advanced Practice Providers; Director, EM/APP Residency Program, Assistant Professor
Duke University Medical Center

Sharon Mace
Sharon Mace, MD, FACEP, FAAP
Director, Observation Unit, Cleveland Clinic Author, Observation Medicine: Principles and Protocols

Christopher McStay
Christopher McStay, MD, FACEP, FAWM
Chief, Clinical Operations; Associate Professor, Department of Emergency Medicine
University of Colorado School of Medicine

2:00 pm

Streamlined care in a designated closed unit for patients under observation status has the potential to improve patient care, while benefiting both the emergency department and the hospital. Although it has great potential to improve efficiency and patient outcomes, there are many issues involved with the transition to a designated closed unit for patients under observation status. In this session, uncover the obstacles and learn how to manage a highly productive closed unit.

  • Review the pros and cons of the various types of observation units to understand the key optimal observation unit
  • Discuss how to get buy-in in order to have a successful closed unit
  • Examine protocols, guidelines, pathways, and order sets that can be implemented to transition to and sustain a closed unit
Sharon Mace
Sharon Mace, MD, FACEP, FAAP
Director, Observation Unit, Cleveland Clinic Author, Observation Medicine: Principles and Protocols

2:45 pm

With higher emergency room volume and stricter conversion criteria, the number of hospital-based observation units has increased exponentially. Given the importance of health care sustainability, it is crucial that observation optimization be at the forefront of hospital and health systems strategies. In this session, hear how an organization initially with high observation lengths of stay, long discharge-to-door times, and inefficient emergency room through-put developed and implemented a multidisciplinary approach to make observation care more efficient.

  • Standardize multidisciplinary rounds approach and discharge process to optimize your observation services
  • Discuss how to maintain high patient and employee satisfaction while reducing length of stay
  • Identify metrics and monitor and track key collaborative process indicators within your unit
Jose M. Carralero
Jose M. Carralero, MSN, RN, CMSRN
Advanced Patient Outcome Facilitator
Baptist Hospital of Miami, Baptist Health South Florida

David M. Schneider
David M. Schneider, BSN, RN, CMSRN
Patient Outcomes Facilitator
Baptist Hospital of Miami, Baptist Health South Florida

4:00 pm

Determining patient status and level of care is a complex matter that affects patient outcome and reimbursement received by hospitals and health systems. Having a thorough understanding of utilization review can assist providers with determining the most appropriate course of care and ensure compliance.

  • Review observation documentation requirements for Medicaid, Medicare, and private insurers
  • Understand tactics and alternative approaches used to determine patient status
  • Understand the impact of utilization management on observation length of stay
  • Understand the metrics used to assess the potential regulatory impact of your UM process
  • Outline the role of the attending physician in UM activities
  • See utilization management as a system-level activity that begins with the clinical evaluation
Ryan Greiner
Ryan Greiner, MD
Medical Director, Hospitalists and Observation Services; Physician Advisor, Utilization Management and Clinical Documentation
North Memorial Health

Deborah Warhol
Deborah Warhol
Systems Utilization Management Manager
North Memorial Health

4:45 pm

Observation units are frequently used to evaluate and treat common conditions such as chest pain and asthma in order to reduce length of stay and the associated costs of care. However, that is just the tip of the iceberg. The benefits of an observation unit can be leveraged to increase ED and inpatient unit capacity, reduce ED length of stay and reduce readmissions for high profile diagnoses such as CHF and COPD. Lastly, an ED Observation Unit is an effective method to reduce unnecessary, expensive ED visits for patients with chronic medical conditions. In this session, we will take a deep dive into finance and reimbursement for an observation unit and understand why it can be used to decrease costs while still offering high care.

  • Discuss the various impacts an observation unit has on the hospital and its stakeholders
  • Project the cost-revenue of having a unit to determine ROI
  • Analyze the financial value of an observation unit in regards to cost effectiveness and reduced readmissions
Anthony Guarracino
Anthony Guarracino, DO, MHA, FACEP
Chair, Department of Emergency Medicine
UPMC Pinnacle

5:30 pm

With an expected increase in aging population, it has becoming increasingly crucial to understand the intricacies involved with delivering care for aging baby boomers. These patients do not always fit the criteria frameworks set by hospitals, making it difficult to determine the appropriate level of care. Discuss how observation units can play a significant role in hospitals and health systems to better manage care required for this population.

  • Leverage lessons-learned from common observation care patients to enhance care for elderly patients
  • Identify metrics and benchmarks that can be used to impact outcomes, readmissions and length of stay
  • Augment care coordination between primary care doctors, ED providers, case managers and social workers for improved discharge and care transitions
Melanie Raffoul
Melanie Raffoul, MD, FAAFP
Assistant Medical Director, Observation/Short Stay Unit
NYU Langone Health