Importantly, the OU is an ideal place to address many of the issues that hamper ED discharge and have been associated with early readmission in patients with HF (Table 2). OU management is compelling for HF management for several other reasons. First, a high proportion of patients experience improvement in dyspnea during their ED stays as a result of standard therapy (27). Many have complete resolution within 24 hours of initial therapy, which is the typical time period of observation. Second, the monitoring of blood pressure, heart rate, urine output, and body weight can be readily provided in the OU. Third, the simple diagnostic testing that occurs during an inpatient admission, such as electrolyte testing, echocardiography, B-type natriuretic peptide or N-terminal pro–B-type natriuretic peptide, and serial troponin measurements can easily be performed in the OU. Fourth, HF education and arranging outpatient follow-up are key components of OU management. These 2 key tasks are associated with decreased readmission, are incorporated in recently updated American College of Cardiology and American Heart Association performance measures, and are key components of OU management ((28),(29),30). Nonetheless, OU management for HF continues to be vastly underused.