This OWL (outpatient work-up liaison) would not fly. Environmental factors foil attempt to shift unnecessary inpatient days to the outpatient setting.

The last days of many appropriate hospital admissions have been identified as unnecessary when utilized for providing diagnostic or therapeutic modalities that could be provided in an outpatient setting. An outpatient work-up liaison team (OWL) was established to facilitate the completion of evaluations or therapy in the community. In spite of the commitment of experienced personnel and the cooperation of the staff physicians and hospital departments, the effort was unsuccessful. The failure is attributed to the socioeconomic environment in the immediate community that could not support the transfer of medical efforts. It is recommended that before any institution undertakes shifting hospital-based services to the community a realistic assessment be made of the socioeconomic milieu.