Advertisement

Journal of General Internal Medicine

, Volume 19, Issue 3, pp 266–268 | Cite as

Hospitalists and an innovative emergency department admission process

  • Eric E. HowellEmail author
  • Edward S. Bessman
  • Haya R. Rubin
Innovations In Education And Clinical Practice

Abstract

After treatment in an emergency department (ED), patients often wait several hours for hospital admission, resulting in dissatisfaction and increased wait times for both admitted and other ED patients. We implemented a new direct admission system based on telephone consultation between ED physicians and in-house hospitalists. We studied this system, measuring admission times, length of stay, and mortality. Postintervention, admission times averaged 18 minutes for transfer to the ward compared to 2.5 hours preintervention, while pre- and postintervention length of stay and mortality rates remained similar.

Key Words

patient admission emergency medicine hospitalist 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Meggs WJ, Czaplijski T, Benson N. Trends in emergency department utilization. Acad Emerg Med. 1999;6:1030–5.PubMedGoogle Scholar
  2. 2.
    Andrulis DP, Kellermann A, Hintz EA, Hackman BB, Weslowski VB. Emergency departments and crowding in the United States teaching hospitals. Ann Emerg Med. 1991;20:980–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Bazarian JJ, Schneider SM, Newman VJ, Chodosh J. Do admitted patients held in the emergency department impact the throughput of treat-and-release patients? Acad Emerg Med. 1996;3:1113–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Quick G. Time analysis of consult service emergency department admission process compared with emergency medicine service admission process. J Emerg Med. 1999;17:815–22.PubMedCrossRefGoogle Scholar
  5. 5.
    Wachter RM, Goldman L. The hospitalist movement 5 years later. JAMA. 2002;287:487–94.PubMedCrossRefGoogle Scholar
  6. 6.
    Schneider SM, Gallery ME, Schafermeyer R, Zwemer FL. Emergency department crowding: a point in time. Ann Emerg Med. 2003;42:181–4.CrossRefGoogle Scholar
  7. 7.
    Schull MJ, Lazier K, Vermeulen M, Mawhinney S, Morrison LJ. Emergency department contributors to ambulance diversion: a quantitative analysis. Ann Emerg Med. 2003;41:477–80.CrossRefGoogle Scholar
  8. 8.
    Freeman JL, Fetter RB, Park H, et al. Diagnosis-related group refinement with diagnosis- and procedure-specific comorbidities and complications. Med Care. 1995;33:806–27.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  • Eric E. Howell
    • 4
    • 2
    Email author
  • Edward S. Bessman
    • 1
  • Haya R. Rubin
    • 2
    • 3
  1. 1.the Department of Emergency MedicineThe Johns Hopkins Bayview Medical CenterUSA
  2. 2.Quality of Care Research, Department of MedicineThe Johns Hopkins School of MedicineBaltimore
  3. 3.Departments of Epidemiology and Health Policy and ManagementThe Johns Hopkins Bloomberg School of Public HealthBaltimore
  4. 4.Department of MedicineJohns Hopkins Bayview Medical CenterBaltimore

Personalised recommendations