Background: Historically, patients transferred from one hospital to another are admitted through the emergency department and then placed on the desired unit at the accepting hospital. This practice creates delays for critically ill patients in need of continuous ICU care. A strategy known as the direct admission addresses this issue. With this strategy, transfer patients [...]

Background: Direct admissions (DA), wherein patients are non-emergently admitted to the hospital, bypassing the emergency room (ER), makeup 15% of non-elective adult hospitalizations (1). DAs can reduce ER volumes (2), but may lead to delays in initial evaluation of patients and inappropriate admissions (2,3). DAs carry risks involved with transitions of care and handoffs, yet [...]

Background:  Direct hospital admissions from outside emergency departments and hospitals comprise a large proportion of admissions to tertiary medical centers. Clinical stability in these acutely ill patients can fluctuate, even during transport to a receiving medical center. Here, we report data obtained as part of an internal quality improvement initiative to identity clinical criteria present [...]

Background: Hospital-at-Home (HaH) is a novel care model providing inpatient care for patients in their home through a combination of home visits and virtual care. Advanced Care at Home (ACH), UNC Health’s HaH program, launched in 2021, has facilitated over 2,000 admissions to date. The majority of HaH care is provided under the terms of [...]