Background: Novant Health is a leading healthcare provider in North Carolina, with 15 hospitals and 14 ambulatory surgery centers across the state. In the preoperative assessment arena, there are currently ten pre-admission testing clinics that are staffed by either hospitalists, anesthesia providers, or both. Variable preoperative assessment criteria exist for each surgical location, with no [...]

Background: Many studies have demonstrated the negative effects of emergency department (ED) crowding on outcomes, including increased length of stay, inpatient mortality, and risk of readmission. Early evidence suggests effective and timely triage of patients with hospitalist input can mitigate some of the detrimental effects of ED crowding. In contrast to prior studies focused on [...]

Background: Telemedicine emerged as an innovative approach to addressing staffing shortages for hospitalists in resource-limited areas (1), the COVID-19 surge (2), and off-hour shifts (3). Telemedicine can be adapted to non-traditional hospitalist roles, i.e. the triagist where a hospitalist assesses patients for potential admissions and supports outpatient to inpatient transitions (4). Modifying the triagist to [...]

Background: To mitigate COVID-19 related hospital crowding, our hospital internal medicine (HIM) department collaborated with our emergency department (ED) to launch a service in which an HIM team was placed in the ED to assist with triage. The goal was to expedite patients with a clear need for admission, while diverting others who could be [...]