Hospital Observation Services

By: Ahmed Afaal, MD

In hospitals, observation services are mainly referred to as

The use of a bed and periodic monitoring and/or short term treatment by a hospital’s nursing or other staff  (BCBSNC)

Observation is a reasonable and necessary process to evaluate a patient’s condition to determine whether there is a need for the patient to be admitted hence is recognized as an alternative method of evaluation and treatment to inpatient hospitalization. It can even be classified as an outpatient service rather than a hospitalization.

The allocated length of stay at observation services may not be the same in different institutions. Ideally, the earlier a patient is discharged from an observation service, the better. The time allowed at an observation service may vary from few hours to a maximum of about 48 hours. Observations services, in some hospitals may even be developed separately with separate policies for different conditions, while in others common policies with common observations services are also provided. In the Maldives, it is mainly the latter that is practiced.

Different categories of patients can be put under observation for the reasons specified below.

• Patients who arrive in the hospital in an unstable medical condition would be placed for observation till a definitive care plan can be determined.
• Patients who develop unusual reactions to procedures and or medicines after minor outpatient surgical procedures are also placed for observation for further assessment and treatment.
• Diagnostic testing that require a specific preparation or an invasive procedure maybe placed at observation before and after the intervention.
• Some patients are also placed in observation for planed routine therapeutic services that require the patient to be observed after the treatment.

Given the above categories, patients who utilize the observation services should mainly be discharged after observation. Hospitalization an inpatient should be very low from the observation room.