Department Spotlight: Clinical Decision Unit

By: Alana Ridge

June 14, 2024

A collage of the Clinical Decision Unit at Renown Health.

Entering the emergency room (ER) is intimidating for any person, let alone when you’re unsure what condition or illness you might have. Many may also spend their time in the ER wondering if they will need to be admitted to the hospital. 

Now, let’s say you don’t need to be admitted. That’s great news! But in order to figure out what’s going on in your body, you may need to stay a little longer – say, under 24 hours – for observation, tests or further treatment. This work is done swiftly by a specific team at the hospital to get you home sooner. 

That team at Renown Health is the Clinical Decision Unit (CDU). These nursing and acute care professionals seamlessly fill in the gaps between inpatient and outpatient care, helping patients return home sooner through rapid tests and treatment. 

Quick Interventions for Efficient Care

The key goal at the forefront of the CDU’s patient care philosophy lies in their name: decisions. The team makes quick decisions in order to deliver timely, accurate assessments so they can treat patients efficiently and get them home. Not only do these efforts help reduce the amount of time patients have to stay in the hospital, but they also achieve cost savings for both the patient and our health system. And in cases where patients do end up needing to be admitted, the CDU walks them through everything they can expect during their stay. 

The main duties of our CDU team include: 

  1. Observation and monitoring, where patients with conditions that are not immediately life-threatening but need closer monitoring
  2. Diagnostic testing, including blood work and imaging, to help providers gather critical information quickly
  3. Treatment and stabilization to receive treatments like IV fluids, medications or other therapies to prevent the need for inpatient admission
  4. Decision-making to determine whether the patient should be admitted for further care or discharged with follow-up plans 

Think of the CDU as the ER and inpatient admission go-between. By diverting patients who don’t necessarily need emergency intervention away from the ER, the CDU helps relieve high patient volumes and reduce wait times. 

“The CDU offloads patients from the emergency room who require slightly longer observation status to complete more complex testing or exams,” said Kristine Barnes, RN. “You could consider us a ‘limbo’ unit between the ER and admission to the hospital, if required.” 

As with many other teams at Renown, every day is different for this team. They enjoy the variety of cases they see and solving the puzzles that present with patient care. 

"The CDU is always fast moving, with discharges and admissions all day,” said Tyler Cathcart, Acute Care Technician-Advanced. “As an observation unit, we function as both an extension of the ED and PACU, with Medical, Telemetry and post-op patients. We have a wide range of patients and responsibilities to keep the unit moving quickly.” 

“We see a variety of patients and enjoy the variety each day brings,” added Angie Marrale, Acute Care Technician-Basic. “A day in the life as a tech on CDU is full of surprises because we have such a wide variety of patients. It requires all team members to be attentive, hardworking and communicative in order to provide our patients with the care they need.” 

If you’re ever looking for an example of a team that moves and acts quickly, the CDU is a shining example of that. Due to their hyper-focused attention, patients are able to embrace better outcomes and higher satisfaction. 

“We move quickly to get today's group of patients comfortable, complete the tests ordered, make the appropriate interventions and get them discharged back home or transferred in less than 24 hours; then, we refill the unit, and each patient receives excellent, expedited care,” said Tyler Cathcart. “Efficient patient care within 24 hours is our goal, and we strive to meet that goal daily.” 

A place to get extra care and attention without needing to stay for a long time while also having a team of professionals solely dedicated to figuring out what is going on in your body? Sign us up! 

Nursing at Renown Health

Angi, Renown ICU Nurse

Nursing at Renown Health

Nurses at Renown Health demonstrate a commitment to patients and their families through integration of care, clinical expertise, education, evidence-based practice and the pursuit of quality patient outcomes.

With You Every Step of the Way

The hospital environment, especially the ER, can be a worrisome experience for some patients, regardless of the condition. When you don’t know what’s going on, that feeling of uncertainty can exacerbate quickly. This is precisely where the CDU can come in. 

One of the most significant benefits of the CDU is the team’s ability to relieve patient fears and anxieties by offering close, continuous care and constant communication.  

Patients are never alone. And the CDU always does their best to help patients understand the tests being done, what the results mean and what the next steps will be, which help alleviate the uncertainty that often comes with health problems. 

“To reduce patient anxiety, we usually explain how the unit works and what the plan is for their case; we also make conversation and get to know their situation quickly, all while attaching Tele monitors, transporting them, doing their admission screening and more,” said Tyler Cathcart. “I try to reassure the patients that their symptoms are no mystery to us, the tests are very safe, and our goal is to get them back home to their normal lives within 24 hours.” 

Patients can pick up when their care teams seem tense or unfocused. To this team, body language is just as important as spoken language when communicating with patients and making them feel as comfortable as possible while seeking care in the CDU. 

“Body language and tone are just as important as the words that are said,” added Angie Marrale. “Providing care that is perceived as compassionate, confident and empathetic is how we ensure our patient's anxiety and fears are reduced.” 

Our CDU works very closely with our hospitalists and nurse practitioners to make sure every item on the patient care checklist is crossed off. Each care plan is tailor-made for the patient. The attentive, personalized care the entire team provides helps prevent complications and promote faster recovery, all while keeping them informed and at ease. 

“The CDU nurses work with a dedicated hospitalist and nurse practitioner in efficient rounding and close communication in order to expedite testing and are more often able to send people back home,” said Kristine Barnes. 

“We also emphasize the competence of our doctors, and they are deeply involved in each patient’s care,” added Angie Marrale. “It is unlikely that our patients will need to stay longer than 24 hours, but if the doctors want them to stay longer, we assure them that there is a good reason for it. They are highly skilled at dealing with these situations.” 

The compassionate approach this team takes helps enhance the overall experience at our health system, making the CDU a cornerstone of effective and empathetic care. 

Adaptable Patient Care with a Smile

Medical professionals across the country are at increased risk of burnout. In fact, in 2022, nearly half of all healthcare workers experienced frequent burnout. To help combat that ever-prevalent burnout, the CDU has a great system in place: leading with kindness and camaraderie. 

Relying on each other and “having each other’s backs” benefits both the team and the patient. Their coworkers never hesitate to step up when anyone needs help – and they do it all with a smile. 

“In the CDU, we work closely with our peers in a team-based style that allows for great camaraderie and patient care,” said Kellie Menezes, RN. 

“Despite stressful situations, our team is very supportive of each other and never ceases to put a smile on each other's faces,” added Angie Marrale. 

In the constantly evolving landscape of healthcare, adaptability is a must. The CDU are experts in adapting to many situations on the floor, providing best-in-class flexible care and adjusting to emerging healthcare needs. 

“I think our team is proud of how fast we can adapt,” said Angie Marrale. “We have become more efficient at getting patients where they need to be hospital-wide.” 

So, how did these employees choose a career in the CDU in the first place? 

The journey each of these team members took to end up at the CDU was a unique one. Many of these devoted individuals were drawn to the mission and vision of the CDU during their clinical rotations, inspired by the distinctive ways the team cares for their patients while also building upon their skillset. 

“I ended up in the CDU after a rotation during my nursing residency, and in this rotation, I found that I truly enjoyed taking care of CDU patients due to the wide range of diagnoses and medical conditions,” said Kellie Menezes. “This allowed me to maintain my skills in multiple areas of nursing.” 

If you have been looking for a sign to kickstart your career in healthcare, let this be your sign – the CDU, along with many other clinical and non-clinical departments across Renown, are hiring people just like you. And they can’t wait to welcome you with that same smile they give their patients. 

Discover the possibilities at
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