In the USA, in 2008 the total inflation-adjusted cost of heart failure admissions was US$10.7 billion, compared with US$6.9 billion in 1997.2 So heart failure admissions are expensive and there is considerable interest in how we might reduce admissions, thereby reducing costs and leading to an improved quality of life (QoL) for patients with heart failure.3
One solution might be the Observation Unit (OU) proposed by Collins et al.4 as an alternative to hospital admission for patients needing a brief period (under 24 hours) of intravenous diuretic therapy. Observation, by definition, is the use of appropriate monitoring, diagnostic testing,