Inpatient Management, Inc. Delivers High Performance Clinical Decision Unit

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"Doing the right thing faster" at Nebraska Medical Center CDU

IMI hospitalists managing our CDU is both good medical and good business practice

Inpatient Management, Inc. (IMI) achieves high performance results both clinically and in cost savings / cost avoidance in the Clinical Decision Unit (CDU) at the Nebraska Medical Center (NMC). IMI assumed management of the CDU in July, 2010. The CDU is a closed unit—IMI’s hospitalists control admissions, management of care and discharge—which empowers the hospitalists to deliver high performance in patient outcomes, patient satisfaction, length of stay and occupancy. The CDU admissions are primarily cardiac-related, but include incidences of respiratory and abdominal pain cases.

“Aggressively and appropriately managing admissions to the CDU is the first critical step in achieving target results for NMC,” said Prasanti Mandalapu, M.D., the IMI hospitalist directing the CDU program. “A closed unit lets us rigorously apply evidence-based medicine (EBM) order sets so that testing, treatment, medical management and discharge are consistent with EBM standards.” Dr. Mandalapu directs an IMI hospitalist team of three mid-level providers that works closely with the NMC emergency department.

“IMI hospitalists managing our CDU is both good medical and good business practice,” said Stephen Smith, M.D., Vice President of Medical Affairs for NMC. “They allow us to utilize our resources in the most efficient manner. We’re controlling inappropriate admissions, increasing our hospital capacity, improving emergency room throughput and capturing additional revenue.” Dr. Smith continued. “All of the patient care is protocol driven which allows for consistent management and improved outcomes. A CDU is different than an ‘observation unit’ and the use of protocols allows us to be fairly rigid about who qualifies for placement in the CDU. We feel it is important both from a quality of care standpoint and from a patient satisfaction standpoint to accurately place a patient in the correct bed at the time of presentation. Ninety percent of the CDU patients are able to be dismissed to home which validates our screening process.”

Approximately 70 percent of the CDU admissions are for chest pain. The IMI hospitalists provide the testing, treatment and management of these patients in the CDU, allowing hospital cardiology to devote more time to treatment of patients with interventional cardiology needs. Under IMI management the CDU has met NMC goals, including average length of stay (14 hours) and a 90 percent patient satisfaction score of “very good.” NMC recognized the CDU performance by awarding the unit a “Star” on the hospital’s Walk of Fame after just six months of CDU management by IMI hospitalists.

“In managing the NMC CDU, we’re doing the right thing, faster, for our client,” said Terri Orf, IMI President. “Efficiency in our business is all about making the right decisions in a timely fashion. This model is not only good clinically, but it makes great business sense. By controlling patient flow on the front end, we can now eliminate unnecessary hospital stays and capture additional revenue for NMC.”

About Inpatient Management, Inc.
Inpatient Management, Inc. (IMI), based in St. Louis, Mo., is a national provider of comprehensive hospitalist programs and consulting services. Independently owned and operated since 1997, IMI serves hospital and health system clients across the country, including Alabama, California, Illinois, Indiana, Iowa, Louisiana, Michigan, Missouri, Nebraska, North Carolina, Ohio, South Carolina and Washington. For more information about Inpatient Management, visit


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Mary DeHahn

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