SHM Converge Scientific Abstract ePoster Gallery-Dartmouth Regional Triage (Dart) Hospitalist: Expanding the Triage Role at a Rural Academic Medcal Center to Improve Regional Bed Capacity

Dartmouth Regional Triage (Dart) Hospitalist: Expanding the Triage Role at a Rural Academic Medcal Center to Improve Regional Bed Capacity

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This project describes the creation of a dedicated Dartmouth Regional Triage (DART) hospitalist at Dartmouth-Hitchcock Medical Center, a rural academic medical center facing severe bed-capacity constraints and frequent ED overcrowding. The goal was to improve regional patient flow by redirecting appropriate low-acuity patients from the main academic hospital to affiliate hospitals within the same health system.<br /><br />Before the intervention, the triage hospitalist also handled admissions, consults, and transfer-center calls. These duties were reduced so the new DART hospitalist could focus on identifying and facilitating transfers. The DART team joined daily bed-capacity meetings with affiliate hospitals, reviewed available beds, and coordinated transfers from both the ED and inpatient hospitalist services to regional non-AMC hospitals.<br /><br />In the six months after implementation, the DART hospitalist redirected 143 admissions from the ED and at least 17 inpatients to three affiliate hospitals. Average monthly transfers increased significantly from 10.5 pre-intervention to 26.7 post-intervention. The authors note that this likely underestimates the true effect because some inpatient transfers were not captured in the data, and one affiliate hospital had frequent bed closures due to nursing shortages.<br /><br />The intervention exceeded its financial target by roughly 10-fold and was estimated to produce more than $3 million in annualized cost savings. The authors conclude that a dedicated regional triage hospitalist can meaningfully reduce strain on a rural AMC, increase patient volume at affiliate hospitals, and improve system-wide bed capacity. Future work should improve data collection and examine patient satisfaction, adverse outcomes, and broader effects on bed availability.

Asset Subtitle

David Haughey

Meta Tag

Author List David Haughey, Elisabeth Souther

Category Innovations

Concept DART hospitalist role

Concept Patient Transfer

Concept Regional bed capacity

Concept Transfer Process

Concept Hospital Bed Capacity

Distinguished Finalist

Presenter Organization Dartmouth Hitchcock Medical Center

Presenting Author David Haughey

Track Transitions of Care

Keywords

Dartmouth-Hitchcock Medical Center

DART hospitalist

regional triage

bed-capacity constraints

emergency department overcrowding

patient flow

affiliate hospitals

hospital transfers

rural academic medical center

cost savings

DART hospitalist role

Patient Transfer

Regional bed capacity

Transfer Process

Hospital Bed Capacity