Cardiac Short-Stay Unit (CSSU) opens

The 6th floor of the B building has a different look these days. It's now home to the new Cardiac Short-Stay Unit (CSSU) that opened on Jan. 29, 2002.

The newly remodeled unit features three outpatient and eight inpatient beds and centralized, state-of-the-art cardiac care services in a restful, quiet atmosphere. The purpose of the unit is to facilitate the evaluation and care of patients suspected of having unstable angina or minor myocardial infarction, as well the care of patients after cardiac procedures. "What we have tried to do is to localize these patients, and we've made a more structured attempt to centralize everything required for their care," explained cardiologist Steve Goldsmith, MD, who was instrumental in developing the unit.

Before having a dedicated short-stay unit for potential cardiac patients, these patients were mixed in among the others on the telemetry unit, A6, the Cardiac Care Unit, or elsewhere depending on bed availability. Often, the Emergency Department (ED) had to serve as the monitoring area for individuals experiencing chest pain or other cardiac symptoms when beds were tight. Sometimes patients would be monitored and tested for up to 12 hours in the ED, which wasn't the best utilization of resources. Now they can be monitored in the comfort of the new short-stay unit, allowing more ED beds, as well as the beds on A6, to be available for more appropriate uses. "We hope that when paramedics are bringing someone in with chest pain, they will consider taking them to HCMC, knowing that the patient will be triaged, monitored, and given an appropriate plan of care in the CSSU," said Goldsmith.

Improved diagnostic testing and triage are important features of the new unit. Point-of-care troponin measurement, facilitated stress tests (appointment slots are kept available for CSSU patients), and bedside telemetry are some of the centralized diagnostic tools being used in the CSSU. To avoid delays, labs are drawn at the patient's bedside and processed right away. The bedside troponin test (to assess cardiac proteins that are indicative of heart muscle damage) can be processed at the CSSU nursing station, where results are obtained within 15 minutes.

In addition to monitoring to rule out myocardial infarction, the CSSU also cares for patients who are scheduled for angiograms and other outpatient cardiology procedures. After patients are admitted to the unit prior to their procedure, nurses get vital signs, set up an IV, and complete any other preparations needed. When patients return to their room after the procedure, they are carefully monitored throughout the recovery period. "Previously, they were seen on A6 and might stay longer than they needed to," explained Goldsmith. Now, with staffing more synchronized to the specific care needs of short-stay patients, they don't get "lost" among the more critical patients and their condition can be assessed in a shorter time frame.

So far, eight nurses (trained in telemetry), five health care assistants and one patient services coordinator have been hired to staff the CSSU. Karen McCampbell, RN, supervises the unit. "CSSU patients are fairly independent in comparison to A6. And although they are not as sick, they still need to be monitored with telemetry. That's why having a designated unit better utilizes human resources - one nurse can care for more patients on the CSSU."

Is having a condition-specific short-stay unit becoming a trend in health care? "There may be a spillover effect to other units on how to do things more safely and efficiently," Goldsmith agreed. "But these patients now represent a significant percentage of admissions to the medicine service at HCMC, and we think we can handle more of them, so we hope that this new unit will be attractive for individuals seeking prompt, specific cardiac care."