Use of an observation ward in a community hospital.

A six-bed observation ward has been an integral part of our community hospital emergency department for 10 years. During a recent 4-month period, 574 patients were admitted with 65 different clinical presentations. Length of stay, treatment, complications, and disposition were evaluated. An estimated 1.7 hospital admissions per day were avoided at an annual cost savings of $240,000. Guidelines have been developed which avoid most potential pitfalls in the use of an observation ward. Significant flexibility is gained and improved patient care is possible with the addition of an observation ward to the emergency department.