In 2021, Oregon Health & Sciences University in Portland created the intake hospitalist role, a dedicated position to oversee patient transfers. In the years since, the academic health center has seen patient safety and physician experience improvements, according to a case study published Oct. 18 in NEJM Catalyst.
Prior to this initiative, hospitalists overseeing incoming transfer requests at OHSU were also managing their usual clinical and teaching duties. Oftentimes, transfer patients arrived who were clinically unstable and without proper records. Some arrived seemingly without a need for a higher level of care. In response, the intake hospitalist role was created.
OHSU describes the role as "a dedicated and specially trained hospitalist without other clinical and educational duties, who manages all direct admissions, intrahospital transfers of service, and interhospital transfer requests to the Medicine service," with the overall goal being to improve quality and safety and "accept 'the right patient, at the right time, to the right place.'"
The authors found having hospitalists fully dedicated to transfers led to improvements in safety, bed utilization and physician experience. When it comes to the cost of the effort, the authors found it was offset through indirect savings created by the backfill of inpatient beds with higher-complexity patients. The model has since been expanded to similar roles within ICUs and pediatrics.