Background: The classic process for admitting patients from the Emergency Department (ED) to inpatient services relies on inefficient phone calls, often leading to communication breakdowns, delays, and inconsistent documentation of critical patient needs, such as telemetry requirements and appropriate specialty unit placement. At our large, community hospital, this negatively impacted patient safety, throughput, and provider satisfaction. A standardized, electronic handoff process between ED and hospital medicine, with bed board (i.e., patient logistics) embedded into the tool, was proposed as a potential strategy to mitigate these challenges.
Purpose: To improve Emergency Department provider to hospitalist communication of patients eligible for admission, with the incorporation of bed board in the communication and shared decision-making.
Description: A PHI secure, streamlined electronic handoff tool separate from the EHR, between ED providers and hospitalists, with oversight by bed board, was developed. Microsoft Forms and Power Automate were utilized to initiate a Teams chat. It included mandatory fields for telemetry indication and specialty unit requirements and was tested by an interprofessional team. Using rapid PDSA cycles of improvement, the tool was refined, and now is the standard of practice. An unintended but beneficial outcome of creating a 24/7 uniform process was the restructuring of the nocturnist workflow to allow for role clarity and efficiency.
Conclusions: Preliminary data indicates an improvement in ED and hospitalists’ perception of their interprofessional communication (Fig. 1). Data for telemetry admissions and patient placement on specialized units (oncology, orthopedic, etc.) show more adherence to evidence-based telemetry guidelines and appropriate patient placement. The tool has been used to triage and admit over ten thousand patients since February 2025, showing its scalability and ease of use. This unique tool allowed for increased engagement and satisfaction for not only hospital medicine and emergency medicine providers, but also clinical and nonclinical team members from the bed board team.
