Emergency department observation units: A scoping review

Area of Science:

• Emergency Medicine
• Health Services Research

Background:

• Dedicated emergency observation units are increasingly utilized for patient management.
• Existing research often focuses on specific aspects like diagnoses and financial implications.

Purpose of the Study:

• To conduct a scoping review of research on emergency observation units.
• To identify knowledge gaps concerning patient care, diagnoses, clinical outcomes, finances, and health system comparisons.

Main Methods:

• The review followed the Joanna Briggs Institute (JBI) methodology.
• Searched databases included MEDLINE/PubMed, Embase, and CINAHL, supplemented by Web of Science for gray literature.
• Two independent reviewers screened and extracted data, with discrepancies resolved by consensus or arbitration.

Main Results:

• 461 articles met inclusion criteria, with a majority focusing on cardiac diagnoses (24%) and adult populations (70%).
• Common outcome measures included length of stay (41%) and morbidity/mortality (41%).
• Few studies addressed staffing models (26%), while hospital finances (35%) and comparisons to other observation methods (26%) were more common.

Conclusions:

• Research on emergency observation units frequently covers reimbursement and cardiac conditions.
• There is a significant paucity of research on staffing models and a broader range of diagnoses.
• The review identifies key areas for future research in observation medicine to address these identified gaps.