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New facility at St. Pats eases care between ER treatment and inpatient admission

Carol Bensen, chief nursing officer at Providence St. Patrick Hospital, visits the Clinical Decision Unit on Thursday, Oct. 1, 2020. The new facility is set to open in the coming days. (Martin Kidston/Missoula Current)

Patients caught between the need for emergency room care and inpatient admission will find new room at Providence St. Patrick Hospital, which unveiled its new Clinical Decision Unit on Thursday.

The 10,000 square-foot facility, strategically placed between the ER and radiology, is set to open in the coming days, moving the hospital deeper into its 10-year strategic plan.

“This is part of Phase 1 in that long-term plan to really help us get to where we need to be and meet the community needs over time,” said Carol Bensen, chief nursing officer at St. Pats. “It really increases the capacity of the hospital for inpatient, and it improves the through-put in ER.”

The hospital announced its plans to construct the new unit last September, though Bensen said the plan has been years in the making. The new CDU includes 10 beds, which effectively keeps space open in the ER for more acute cases, along with inpatient beds elsewhere in the hospital.

The facility is designed for patients who don’t need ER care and haven’t yet been admitted to inpatient care for more long-term treatment.

“They can come over here and we can do some rapid intervention or some diagnostic testing,” Bensen said. “After a period of time, we can determine if they do need inpatient admission of if they can go home. It really gives an extended emergency care, but it moves them out of the ER to a different location and frees up ER beds for other patients.”

Hospital representatives have said the CDU is included in the hospital’s Phase 1 expansion plans while a new $126 million medical building planned on an adjoining lot represents Phase 2. Once the work is complete, Phase 3 would likely include back filling parts of the existing hospital.

The new CDU includes 10 beds and is designed for patients who don’t need ER care and haven’t yet been admitted to inpatient care for more long-term treatment. (Missoula Current)

On Thursday, crews placed the final touches on the new facility and the rooms were equipped with beds and monitors. The new CDU makes more efficient use of resources while offering potential savings to patients who may not need full admission to a hospital bed.

“It’s considered extended outpatient care, so an extension of the emergency department,” said Bensen. “But it’s a different pay structure than if someone’s admitted, so its less expensive for the patient to be cared for in an environment like this.”

Bensen said a patient would likely be placed in the CDU for 16 to 23 hours at most. A physician will determine if they need to be admitted for impatient treatment or sent home.

“It also removes the illusion that they’re on an inpatient bed and therefor an inpatient,” she said. “We’re really clear to them that this is a continued outpatient setting, and things happen more rapidly here than they might in an impatient unit.”

Such observation units have been around for decades. Bensen said they began nationally as “chest pain centers.” Back then, medical staff were reluctant to send such patients home too soon out of a risk of something happening once they left.

The concept has since expanded to include a wider range of patients.

“It really made it safer for the patient, and when they left they felt more confident they’d be okay,” said Bensen. “If they don’t need admission, we really want to get them out in a period of time and a short number of hours.”