• Am J Emerg Med · Oct 2022

    Level-loading a health system by transferring emergency department patients to a community hospital: Prospective cohort study.

    • Andy H Lee, Yosef Berlyand, Peter F Dunn, Eric Goralnick, Lien H Le, Ali S Raja, Joshua J Baugh, Stephanie Cooper, and Brian J Yun.
    • Harvard Medical School, Boston, MA, United States of America; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States of America; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States of America. Electronic address: alee85@partners.org.
    • Am J Emerg Med. 2022 Oct 1; 60: 293329-33.

    BackgroundEmergency department boarding and crowding lead to worse patient outcomes and patient satisfaction.ObjectiveWe describe the implementation of a program to transfer patients requiring medical admission from an academic emergency department to a community hospital's medical floor and analyze its effects on patient outcomes.MethodsA prospective cohort study was performed. Data was collected on patient flow through the transfer program. Patient characteristics, boarding time in the emergency department, and hospital-based outcome measures were compared between patients in the transfer program who were successfully transferred to the community hospital and patients who were admitted to the academic medical center.Results79 patients were successfully transferred to the community hospital between November 23, 2020 and August 5, 2021, resulting in 279 bed days in the community hospital. Successfully transferred patients experienced a statistically shorter ED boarding time (5.7 vs. 10.9 h, p < 0.0001), ED length of stay (10.5 vs 16.1 h, p < 0.0001), and hospital length of stay (3.5 vs 5.7 days, p < 0.0001) compared to patients initially referred to the transfer program who were admitted to the academic medical center. There were no reported adverse events during transfer, upgrades to the ICU within 24 h of admission, or inpatient deaths for patients who were transferred.ConclusionWe implemented an academic emergency department to partner community hospital transfer program that safely level-loads medical patients in a healthcare system.Copyright © 2022 Elsevier Inc. All rights reserved.

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