Journal of General Internal Medicine

, Volume 34, Issue 10, pp 1968–1970 | Cite as

A Retrospective Cohort Study of the Effect of Hospitalist-Directed Transfers on Patient Flow

  • Yihan Chen
  • Inderpreet Saini
  • Shivani K. Patel
  • Holly Wilhalme
  • William D. Miller
  • Roswell QuinnEmail author
Concise Research Reports


Emergency room (ER) overcrowding occurs frequently and can result in poor clinical outcomes. Active bed management by hospitalists has been shown to improve ER patient flow without negative impacts on clinical outcomes.1 Studies from Korea have shown transfers to regional hospitals can reduce ER lengths of stay (LOS) for patients awaiting admission, though by an average of less than 2 h.2, 3 Despite these modest reductions in ER LOS, transfers directed by hospitalists may help alleviate ER overcrowding.

Our hospital system began a hospitalist-directed transfer process to reduce ER overcrowding in 2011 by developing a process for intra-health system transfers. As part of the process, hospitalists at a referral center ER screen patients based on clinical judgment for transfer and directly admit consenting patients to an affiliated hospital with greater bed availability. To assess the impact and safety of this hospitalist-led intervention to reduce ER LOS, and thereby...


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  • Yihan Chen
    • 1
  • Inderpreet Saini
    • 1
  • Shivani K. Patel
    • 2
  • Holly Wilhalme
    • 3
  • William D. Miller
    • 4
  • Roswell Quinn
    • 1
    • 5
    Email author
  1. 1.Department of Medicine, David Geffen School of MedicineUniversity of CaliforniaLos AngelesUSA
  2. 2.Department of MedicineCedar-Sinai Medical CenterLos AngelesUSA
  3. 3.Department of Medicine Statistics CoreUniversity of California Los AngelesLos AngelesUSA
  4. 4.Department of Medicine, Section of Pulmonary and Critical CareUniversity of ChicagoChicagoUSA
  5. 5.Hospitalist Division of the Department of Medicine, Hospitalist Service VA Greater Los Angeles Healthcare SystemLos AngelesUSA

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