b'The launch of the COU began as a pilot within one of the hospitals inpatient units in order to identify opportunities for improvement . Changes immediately began to be evident on the pilot unit, as the average length of stay for observation-status patients hospital-wide decreased from 28 hours in other hospital units to under 24 hours in the COU. The cost-savings related to staffing is approximated at half a million dollars . In addition, there has been a reduction in supplies of $10,000/month, actual vs . budget .After careful consideration of the pilot units success,Below: New unit opening February 2019the COU opened in its permanent location in February of 2019 . The COU transformed what was previously a unit with a mix of infant inpatient and all-ages outpatient beds into a full 14-room all-ages observation unit . The new unit provides 24-hour coverage by the attending hospitalist physician during the day, and by the medical resident and APRN at night . Surgical Services coverage was provided to patients under the care of the surgical team on a 24-hour basis . Creating the playbook for the COU was not an easy feat, but across the board, outcomes showed overwhelming success . Some obstacles that were quickly overcome included changing the mindset of the unit staff and providing education to multiple disciplines and departments, effectively creating guidelines that were in alignment with the facilitys governing bodies . The hospital and unit leadership worked diligently to provide a smooth transition for the units staff. In addition to education in their newbegan to report increased engagement and satisfaction role, funds were provided to purchase jackets forwith their new roles . A celebration was held both at the nurses with the Clinical Observation Unit logo toopening of the unit and for the one- year anniversary . wear during their shift . Although the transition forAdditionally, clinical excellence index scores were not nurses from caring for patients with longer stays to annegatively affected with the new staffing model and observational setting was challenging at first, nursesservice excellence index goals were exceeded . 32 Nicklaus Childrens Hospital'