SHM Converge Scientific Abstract ePoster Gallery-Telehospitalists Optimize Medical Triage in Community Emergency Departments and Hospitals

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This Mayo Clinic pilot studied a telehospitalist program designed to improve triage and medical management for patients presenting to four community emergency departments (EDs) from January 2022 through April 2023. The goal was to help ED clinicians decide which patients could be safely discharged home, admitted locally, or transferred to a tertiary care center.<br /><br />ED clinicians marked patients as “admit likely,” and telehospitalists proactively reviewed them and collaborated on disposition decisions. Among 550 evaluated patients, 20% were discharged home, 58% were admitted locally, and 22% were transferred to the tertiary hospital. Patients discharged home had shorter ED length of stay than those admitted or transferred, and only 18% of discharged patients returned to the ED within 7 days.<br /><br />Importantly, hospital outcomes were similar between local admissions and tertiary transfers: hospital length of stay and in-hospital mortality did not differ significantly. The program safely avoided an estimated 164 hospital bed-days by discharging 109 patients home, helping preserve capacity for higher-acuity patients. It also reduced unnecessary interhospital transfers by supporting local admissions when specialized care was not required.<br /><br />The authors conclude that telehospitalists can safely optimize patient triage, support community EDs under capacity strain, and improve bed utilization across a regional health system. A key limitation was the lack of a matched comparison group, since randomization was not feasible in the setting of healthcare strain.

Asset Subtitle

Adam Koch

Meta Tag

Author List Adam Koch, Donna Lawson, Karen Fischer, M. Caroline Burton, Rachel Keuseman, Riddhi S. Parikh, Sagar Dugani, Sandeep R. Pagali, Shant Ayanian

Category Innovations

Concept Telehospitalist Program

Concept Medical Triage

Concept Patient Disposition

Concept Tertiary Transfer

Concept Community Emergency Department

Distinguished Non-Finalist

Presenter Organization Mayo Clinic, Rochester, MN

Presenting Author Adam Koch

Track Transitions of Care

Keywords

telehospitalist

emergency department triage

patient disposition

community emergency departments

hospital admission

interhospital transfer

bed utilization

ED length of stay

regional health system

telemedicine

Telehospitalist Program

Medical Triage

Patient Disposition

Tertiary Transfer

Community Emergency Department