Konnyu, K.J., Kwok, E., Skidmore, B., & Moher D. (2012). The effectiveness and safety of emergency department short stay units: a rapid review. Open Medicine, 6(1). Retrieved from http://www.openmedicine.ca/article/view/478/449.
Emergency department (ED) overcrowding has been defined as “a situation where the demand for emergency services exceeds the ability to provide care in a reasonable amount of time.” ED overcrowding is a serious and ongoing issue across Canada; in a 2006 survey of Canadian ED directors, 62% of respondents reported that overcrowding had been a major or severe problem in 2004 and 2005.
Short stay units (SSUs) have emerged as a potentially useful strategy for managing overcrowding in emergency departments. The theoretical benefit of SSUs is to “off-load” stable patients from the acute-care ED and to reduce the number of unnecessary hospital admissions. Typically, SSUs are focused on (1) expected short treatments such as blood transfusions; (2) further diagnostic investigations to finalize a medical diagnosis; and (3) safe discharge into the community, such as by involving a social worker. To prevent such units from being “dumping grounds,” most SSUs have strict inclusion/admission criteria. Part of the difficulty in evaluating the value of SSUs is terminology, since many terms have been used to describe such units (e.g., observation units, assessment units, and clinical decision units). Typically, however, SSUs are some type of extension of the ED whose overarching objective is to improve “the quality of medical care through extended observation and treatment, while reducing inappropriate admissions and healthcare costs.”