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Clinical Decision Unit fills hospital patient niche

St. Vincent Medical Center opens Providence's first CDU in Oregon to better diagnose, treat patients

TIMES PHOTO: JAIME VALDEZ - Dr. Scott Marsal, division chief of medicine and medical doctor for quality and patient safety at Providence St. Vincent Medical Center, shows one of the 26 rooms at the new Clinical Decision Unit at the medical center.It’s not always clear right away how serious patients’ conditions are when they first arrive at a hospital.

Chest pain, abdominal pain, dehydration and loss of consciousness can quickly pass or prove to be deadly serious.

At Providence St. Vincent Medical Center, as with most hospitals, such patients have typically spent much of a day in the emergency room or another room while doctors test, monitor and treat them.

But that changed this week at St. Vincent, which on Monday opened its new Clinical Decision Unit.

Known as the CDU, located just upstairs from the Emergency Department, it will concentrate up to 20 patients who are in a state of medical limbo among experts in diagnosing and treating their symptoms. Six additional rooms in the unit later will provide kidney dialysis for admitted patients.

The result, St. Vincent’s hopes, is better care for those patients, plus the potential to ease crowded conditions in the emergency room and free up space elsewhere in the 523-bed hospital.

The benefits will also eventually reach beyond the hospital, said Dr. Scott Marsal, division chief of medicine at the hospital.

“There’s efficiency gains by concentrating this population of patient here,” he said. “That means the costs are lower. That’s a benefit ultimately to our communities.”

While in the unit, most patients will be on observation status rather than formally admitted to the hospital, which is the same status of patients in the emergency room.

Marsal believes that 80 to 90 percent of the CDU’s patients are likely to go home within 24 hours. A smaller percentage will stay in the unit another day or be admitted to the hospital for treatment of more serious ailments.

St. Vincent opened Providence Health & Service’s first CDU in Oregon, but Marsal said the units are proving successful elsewhere as they open around the country, including at Providence hospitals in Washington and California.

St. Vincent’s CDU also is the first finished component of the hospital’s much larger $85 million renovation.

The ongoing project includes a new building exterior, larger rooms, earthquake-resilient retrofitting and other upgrades to the 1971 building.