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Close Observation Units

A close observation unit (COU) provides an intermediate level of care between a general ward and an intensive care unit. A COU may be established in a hospital with no intensive care service (i.e. a Level 3 COU) or in a hospital with a Level 4, 5 or 6 intensive care service (i.e. a Level 4 COU). These units may have historically been referred to as high dependency units or coronary care units, depending on the scope of services delivered.

Key principles

In order to deliver safe, effective and timely care in a close observation unit, a number of principles are recommended for adoption by local health districts and specialty health networks.

  • Clarity of leadership and governance arrangements
  • Definition of care delivery and coordination mechanisms
  • Documentation of protocols, procedures and treatments
  • Proactive continuous quality improvement practices
  • Structured education and training programs
  • Appropriate workforce and support staff resourcing
  • Availability of necessary equipment to deliver care within the defined scope of the COU

Establishment, governance and operation of a close observation unit: key principles

Implementation tools

Browse Resources