title: Slash diversion, improve care of boarded patients with an ED-based hospital medicine (HMED) team.
abstract: To cut down on diversion time, Denver Health Medical Center in Denver, CO, decided to locate a hospital medicine team in its ED (HMED). The HMED team focuses on streamlining patient flow as well as caring for patients boarded in the ED. The approach has proven successful, slashing diversion by 27% while also increasing discharges from the ED by 61%, according to a pre and post study of the intervention. The HMED team includes a hospitalist and an allied health professional who are both housed in the ED during the daytime shift, from 7 a.m. to 5 p.m. The HMED team spends 75% of its time taking care of admitted patients who are boarded in the ED, and 25% of its time working on patient flow. Emergency department physicians say having immediate access to an admitting team streamlines the admitting process and helps to ensure that patients are sent to the most appropriate floors for care. A successful HMED intervention requires commitment to the approach from hospitalists, and a willingness among ED staff to have a hospitalist team located in the department, according to hospital sources. A productive relationship between ED physicians and hospitalists is key.
mesh_terms: D003441:Crowding; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D010348:Patient Care Team; D010360:Patient Transfer / Q000706:statistics & numerical data*; D014481:United States