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Observation units — also known as short stay units or clinical decision units — have demonstrated value for evaluating and managing patients with low-risk chest pain or syncope. In 2014, researchers at a New York City academic medical center designed an observation unit to manage acute exacerbations of chronic obstructive pulmonary disease (COPD) by protocol (i.e., bronchodilators, systemic corticosteroids, oxygen, and, if indicated, noninvasive bilevel ventilation). In a retrospective study, all 3700 COPD exacerbations among 1770 patients who visited the emergency department (ED) were evaluated for 1 year before and 3 years after initiation of the observation unit.
A significantly higher percentage of patients were admitted to the hospital …