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Lack of available beds for patients requiring admission is a primary cause of emergency department overcrowding and ED boarding, which in turn are primary causes of ambulance diversion.
Hospitalists at a 335-bed level II trauma center, where the bulk of admissions to the department of medicine come from the ED, hypothesized that having a hospitalist dedicated exclusively to moving patients out of the ED and into hospital beds would reduce ED overcrowding and ambulance diversion. Together, the department of medicine and the ED implemented an active bed-management service by hospitalists 24 hours a day, 7 days a week. This intervention included continuous assessment of bed availability (in the intensive care unit, subspecialty units, and gener…