University of Iowa hospitals opens short-stay unit to help with crowding

AMES — Crowding and capacity needs continue to stress the main University of Iowa Hospitals and Clinics, compelling administrators to expand the emergency department, reorganize existing services and — now — open a new “short-stay unit.”

UIHC opened a new 30-room short-term unit Monday aimed at freeing up patient beds for sicker patients; streamlining the hospital experience for short-term patients requiring observation before heading home; and allowing providers to focus on either critical-care or short-term needs.

Examples of UIHC patients who might require a short hospital stay are those needing further evaluation to determine whether they’re stable enough to be released or should be admitted; patients recovering from surgery; or ER arrivals requiring observation, like those with chest pain, for example.

“This is an important patient population that we’re serving,” Interim UIHC Chief Executive Officer Kim Hunter told the Board of Regents, which was meeting Wednesday in Ames — describing the 30-bed short-stay unit on the lower level of the main campus’ John Colloton Pavilion as “beautiful.”

“All of rooms are private,” she said. “All of the rooms have bathrooms.”

  Buy Photo

Patients might find themselves in the short-stay unit after the operating room or a trip to the emergency room — which has become increasingly stretched in recent years.

After a bit of a dip during the height of COVID-19 pandemic in 2020, total UIHC emergency room visits ticked back up to more than 50,000 in the 2022 calendar year, according to regent documents.

Since 2018, the number of transfer patients that UIHC’s emergency room has taken from other hospitals’ emergency rooms has spiked 30 percent to about 9,000 a year — excluding transfers who were turned down due to space constraints.

Because UIHC has in recent years and months seen sicker, more acute patients presenting in its ER, the department’s average length of stay has jumped to more than five hours. Its emergency department boarding hours have spiked 40 percent since 2018 to more than 140,000 a year.

Aggravating that congestion is UIHC’s high patient census — with, on average, 96 percent of its 627 staffed beds occupied in 2022.

“We have capacity challenges, with a lot of patients and not enough beds at times to meet the needs,” Hunter said. “And so taking patients that need short-term care and putting them in a special unit for them then frees up beds they would otherwise have been occupying in a regular inpatient unit.”

Long-term help

Looking long-term at the capacity strain, UIHC is planning a massive new patient tower and, more immediately, a $37 million two-story expansion of its emergency room. In presenting to the regents that three-phased ER construction project set to begin this summer, officials Wednesday touted the prospect of shrinking wait times through additional ER space and rooms.

“Our wait times over the last few years have increased just because we have greater patient volume coming to the emergency department and we've not expanded the amount of rooms,” Hunter said, pointing to the growing number of prospective patients who show up at the ER only to leave without being seen.

“Patients come, check in, and they decide they don't want to wait any longer and they leave and go elsewhere,” she said. “We want to be able to decrease that so that anybody coming to see us will be able to be taken back to a room and see a provider pretty swiftly.”

The expansion also will address UIHC’s behavioral health care needs, moving the Crisis Stabilization Unit to the ER and adding a new Adolescent Crisis Stabilization Unit, which it’s currently lacking.

“There are certain ways you need to redo rooms so that they're safer for those patients who have behavioral health needs,” Hunter said.

  Buy Photo

Although UIHC officials haven’t shared many details about the planned 842,000-gross-square-foot patient tower — which the campus projects spending $621 million on through fiscal 2028 — the university Wednesday did present to regents an “enabling project” in the form of a $75 million west campus parking ramp.

Construction on that 985-stall, five-level parking ramp on the parking lot just north of Kinnick Stadium and the West Campus Transportation Center is expected to start this spring and continue through fall 2025.

Vanessa Miller covers higher education for The Gazette.

Comments: (319) 339-3158; vanessa.miller@thegazette.com