A Retrospective Cohort Study of the Effect of Hospitalist-Directed Transfers on Patient Flow
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...
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Conflict of Interest
The authors declare that they do not have a conflict of interest.