3 Key Components to an Observation Protocol
Chest pain is one of several chief complaints conducive to an observation protocol, which has 3 key components:
- Patient selection
- Intervention
- Decision
For example, a patient with known coronary artery disease, reproducible chest pain, and a negative first troponin may be the correct patient for observation. The intervention, will be telemetry and a second ECG and troponin. The decision, will be “discharge if second ECG and troponin are negative.”
General Documentation Requirements
- Date and timed order to place in observation
- A short treatment plan regarding the goals of the observation
- A clinically appropriate progress note
- A short discharge summary note including a follow-up plan
There are more specific requirements for each level of patient, including those who are considered moderate and high severity patients, detailed in the podcast.
Financial Considerations
As observation medicine becomes more prevalent, several financial considerations continue to evolve:
- Requirements to discharge to a skilled nursing facility
- Self-administered medications
- Facility payments
- Medicare Part A versus Part D, and the cost of care associated with inpatient versus outpatient status
Learn more about the E-QUAL Network Chest Pain Initiative to review the webinar associated with this podcast.
Author information
The post Chest Pain and Making the Most of Observation: ACEP-EQUAL Network Podcast appeared first on ALiEM.