Health & Medicine

University of Kentucky hospital to open observation unit in hopes of reducing long ER waits

The University of Kentucky Albert B. Chandler Hospital
The University of Kentucky Albert B. Chandler Hospital Herald-Leader

UKHealthCare will announce Tuesday that it is opening a 12-bed unit in University of Kentucky Chandler Hospital that is intended to help to reduce overcrowding in the emergency room and the number of patient readmissions.

"It's the idea of getting the right patient into the right place," said Dr. Bernard Boulanger, chief medical officer.

The 9,000-square-foot, $6 million observation unit will open Thursday and eventually expand to 24 beds.

The UKHealthCare subcommittee of the University of Kentucky Board of Trustees got a preview of the project at its meeting Monday. The new unit is part of the hospital's tower, which has been opening in increments since 2011; with the observation unit, it will be 62 percent full.

The average wait time in the UK hospital's emergency room — measured by the time a patient comes through the door until he or she is moved to a hospital bed — is 10 hours and 44 minutes. That is the longest wait time in Kentucky and 41/2 hours longer than the national average, according to Hospital Compare, a government website where Medicare crunches data on hospitals.

Boulanger said Monday that UK wasn't sure how the new unit would affect wait times. "We have had trouble modeling that," he said.

But, he said, hospitals are finding success with similar units across the country.

There are occasions when patients don't meet the criteria for admission set by Medicaid or Medicare, said Dr. Romil Chadha, who will direct the unit. But, he said, doctors still might want to keep on eye on them before spending them home.

That's where the new unit will come in, Boulanger said. It will allow patients to be monitored without taking up space in more highly specialized units such as the ER. For example, once ER doctors have made sure a patient with chest pain isn't in immediate danger of a heart attack, they might transfer the patient to the observation unit. That would free up trauma specialists in the ER to treat cases that truly are emergencies, he said.

Patients will be able stay in the observation unit for up to 24 hours as outpatients, Boulanger said.

Previously, Dr. Michael Karpf, executive vice president for UK's health affairs, had said repeatedly that the only answer to ER overcrowding was to add more beds to the hospital. Following that logic, Karpf announced in September that UK would ask the state to approve an additional 120 hospital beds through the certificate of need process. The state will make a decision on that request in February.

Boulanger also had said that adding beds was the only answer to ER overcrowding. He said Monday that the observation unit should have been discussed earlier as an option to ease ER overcrowding.

"We should have brought it up because it has been in the plan all along," he said.