• Alice Kidder Bukhman, Christopher W Baugh, and Brian J Yun.
• Brigham and Women's Faulkner Emergency Department, 1153 Centre Street, Boston, MA 02130, USA; Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Neville House 2nd Floor, Boston, MA 02115, USA. Electronic address: abukhman@bwh.harvard.edu.
• Emerg. Med. Clin. North Am. 2020 Aug 1; 38 (3): 647-661.

AbstractAlternatives to inpatient admission have been shown to be safe and effective for a variety of clinical conditions and can help relieve emergency department (ED) and inpatient crowding. Evidence-based alternatives include use of rapid ED follow-up clinics, observation units, and home hospital programs. Use of accelerated diagnostic pathways and shared decision making can help support clinicians and patients in appropriately choosing an alternative disposition to traditional inpatient admission. However, many institutions struggle to fully embrace possible alternative depositions because of challenges of patient access, clinician and patient comfort with diagnostic uncertainty, and perceived medicolegal risks.Copyright © 2020 Elsevier Inc. All rights reserved.

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