Objectives: CDUs have been implemented to address ED wait times. The objectives of this study were to investigate ED team members’ perceptions on the implementation of CDUs as well as the impact of CDUs on the delivery of emergency care. Methods: A case study design and change theories found in the literature were used to investigate the implementation of CDUs in four hospitals. Semi-structured interviews with ED team members led to the creation of themes for analysis. Results: Analysis demonstrated that patient flow, work processes and communication contribute to the type of CDU set-up, whether it is a co-located or virtual CDU. The sustainability of CDUs relies on communication and a common vision in the fulfillment of purposes and goals. Conclusions: This study contributes to the understanding of the implementation of CDUs. The application of change frameworks assists with the identification of key success factors for implementing and sustaining change.

Objectives: CDUs have been implemented to address ED wait times. The objectives of this study were to investigate ED team members’ perceptions on the implementation of CDUs as well as the impact of CDUs on the delivery of emergency care. Methods: A case study design and change theories found in the literature were used to investigate the implementation of CDUs in four hospitals. Semi-structured interviews with ED team members led to the creation of themes for analysis. Results: Analysis demonstrated that patient flow, work processes and communication contribute to the type of CDU set-up, whether it is a co-located or virtual CDU. The sustainability of CDUs relies on communication and a common vision in the fulfillment of purposes and goals. Conclusions: This study contributes to the understanding of the implementation of CDUs. The application of change frameworks assists with the identification of key success factors for implementing and sustaining change.