Background: ED visits increased to 145.59 million in 2016 (CDC 2019), resulting in an increase in hospital admissions. Chen et al. showed a correlation between the overall ED census and likelihood of admission; while, Velasquez et al. found up to 28% of hospitalists reported having admitted patients when no admission criteria were met. They described [...]

Background: Bedside nurses often communicate via alphanumeric (text) paging with hospitalists and other providers. To help the nurse and provider triage the urgency of these messages, our institution has implemented a tiered paging labeling system based on message priority, but the use of this labeling system and the concordance between provider perception and nurse perception [...]

Background: Emergency Department (ED) overcrowding and lack of hospital bed capacity are pervasive problems made worse by the Covid-19 pandemic. Bed capacity is a significant concern at Academic Medical Centers (AMCs), as patients depend upon AMCs for specialized in-hospital care not available at other regional hospitals. Bed capacity shortage is acutely felt at rural AMCs, [...]

Background: Each year 45 million procedures are performed in the United States. For elective procedures, the preoperative evaluation is an opportunity to identify and manage risk factors that may contribute to post -operative morbidity and mortality. Increasingly thispre-operative visit has come under the purview of hospital medicine. While studies have demonstrated that pre-operative evaluations reduce [...]

Background: Our goal was to evaluate the group of patients that are admitted to the Medicine service under the care of our hospitalist team and then transferred to the medical intensive care unit (MICU) within 12 hours of admission, to see if this was a result of incorrect triage or progression of the underlying disease [...]

Background: Triaging patients from the emergency room, an outside hospital or a service-line within your institution can be a challenging endeavor regardless of the size of your group. The Ohio State University Wexner Medical Center Division of Hospital Medicine (DoHM) faculty are the primary attendings for 21 unique service-lines each day across five hospitals. The [...]

Background: The Intermediate Care Unit (IMU) was developed in the 1960s – 1970s as a level of care between general medicine (GMU) and intensive care units (ICU) [1]. The Society of Critical Care Medicine has established guidelines for admitting patients to an IMU based on severity of illness or need for frequent or complex nursing [...]

Background: Despite system-level focus on avoidance of potentially preventable hospitalizations, the decision to admit a patient with low medical acuity has been understudied. Our study sought to identify factors associated with admission versus discharge from the Emergency Department (ED) for patients considered unlikely to be medically appropriate for admission. Methods: We conducted a retrospective cross-sectional [...]

Background: Hospitalists have increasingly engaged in admission decision-making for acute care medical patients. The role, duties, and impact of a Hospital Medicine Triage Attending (“triagist”) are emerging yet ill-defined. To our knowledge, no study thus far has catalogued the activities of these physicians in a comprehensive way. Our objectives were to 1) characterize the demands [...]

Background: Intensive Care Unit (ICU) beds are limited, so effective triage is important for resource utilization. However, inappropriate triage of critically ill patients to non ICU settings can lead to poor patient outcomes, as early unexpected ICU transfers are associated with increased mortality. Purpose: We sought to describe the effectiveness of Hospital Medicine (HM), Emergency [...]