SHM Converge Scientific Abstract ePoster Gallery-Open 24/7: the Impact of Creating a Tele-Nocturnist Program to Support Rural Hospitals

Pdf Summary

This poster describes the development of a 24/7 tele-nocturnist program to support four rural hospitals in South Carolina. The program was launched in January 2025 after a daytime tele-hospitalist model had already been successful at two rural hospitals. The main goal was to improve nighttime coverage, which is often difficult in rural settings because of low patient volumes, high staffing costs, and workforce shortages.<br /><br />The intervention used one tele-nocturnist and one onsite advanced practice provider (APP) from 7 p.m. to 7 a.m. across four hospitals. The tele-nocturnist handled admissions, while the onsite APP managed cross-coverage. Technology included a videoconferencing platform, telehealth cart, Epic secure chat, and Microsoft Teams. The study used a pre/post design comparing January–October 2024 with January–October 2025. Outcomes included hospital volume, throughput measures such as length of stay index and discharge before 10 a.m., in-hospital mortality, cost savings, and nursing satisfaction.<br /><br />The authors hypothesized that tele-nocturnist coverage would improve nighttime staffing stability, continuity of care, transfer rates, and provider cost sharing. Early results suggest positive impact: over 1,500 patients were admitted, representing 35% of total admissions. The model was associated with improved daytime rounding efficiency, more discharges before 10 a.m., shorter length of stay index, fewer transfers, lower mortality, and higher patient and staff satisfaction. The program also generated estimated annual savings of about $25,000 per hospital, or 10%.<br /><br />Overall, the poster concludes that tele-nocturnist care is a feasible, high-value model for rural hospitals, offering around-the-clock physician support while reducing costs and improving care quality.

Asset Subtitle

Emily Reams

Meta Tag

Author List Benjamin W. Barnette, Emily Reams, Kevin Baker, Marc Heincelman, Roger Pons, Yotam Papo

Category Innovations

Concept Tele-nocturnist coverage

Concept Rural Hospital

Concept Nighttime staffing shortage

Concept Pre/post intervention study

Concept Continuity of coverage

Distinguished Finalist

Presenter Organization Medical University of South Carolina

Presenting Author Emily Reams

Track Other

Keywords

tele-nocturnist

rural hospitals

telehealth

nighttime coverage

advanced practice provider

hospitalist model

patient throughput

length of stay

staff satisfaction

cost savings

Tele-nocturnist coverage

Rural Hospital

Nighttime staffing shortage

Pre/post intervention study

Continuity of coverage