CME Course

A Hospitalist-Led Team to Manage Patient Boarding in the Emergency Department: Impact on Hospital Length of Stay and Cost

Hospitalist-led management of admitted patients boarding in the ED has been identified as a potential solution to improve patient flow. The authors sought to examine the impact on patient flow and potential for cost savings by an active management of boarded ED medical admissions by a hospitalist-led team, which included a hospitalist, an advanced practitioner, and a case manager.

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Target Audience

Southern Medical Journal (SMJ) is an interdisciplinary, multi-specialty Journal, and articles span the spectrum of medical topics, providing timely, up-to-date information for primary care physicians and specialists alike. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.  Therefore, the readers of the SMJ are an appropriate target for this article.

Goals and Objectives

Admitted patients boarding in the emergency department (ED) while awaiting inpatient beds represent a bottleneck in patient flow and is recognized as one of the primary causes of ED overcrowding. Studies have shown that hospitals operating at or near maximumcapacity have an increased ED length of stay (LOS), which is associated with multiple negative downstream consequences, including patient dissatisfaction, inappropriate utilization of resources, and decreased quality of care. Hospitalist-led management of admitted patients boarding in the ED has been identified as a potential solution to improve patient flow. The authors sought to examine the impact on patient flow and potential for cost savings by an active management of boarded ED medical admissions by a hospitalist-led team, which included a hospitalist, an advanced practitioner, and a case manager. At the conclusion of the session, learners should be better prepared to:

  • Understand the difficult issues involved with boarding emergency department patients;
  • Analyze your institutional situation to determine if a quality improvement project may be helpful in better managing this category of admitted patients;
  • Develop a QI project for your institution which takes into consider your institution's particular needs and utilize the information from this study.

Course Information

CME Release Date: December 4, 2019
Valid for credit through: December 4, 2020
Course type: CME Journal Article
Estimated time of completion: 1 hour

Credits Available

Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Southern Medical Association designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM MOC: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 Medical Knowledge MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

To receive CME credit and/or MOC points, you MUST complete the activity and the evaluation form. For ABIM MOC points, your information will be shared with the ABIM through the ACCME Program and Activity Reporting System (PARS). Please allow 6-8 weeks for your MOC points to appear on your ABIM records.

AAPA: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of .50 hours of Category I credit for completing this activity.

AANPCP: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Healthcare Professionals
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.  All healthcare professionals who are not MDs or DOs will receive a certificate of participation.

Instructions for Participation and Credit

This activity is designed to be completed within the time designated; learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:

  • Read the goals and objectives, accreditation information, and author disclosures.
  • Login in below to access the article in order to study the educational content and references.
  • Review the clinical scenario provided within the course
  • Complete the post-test by choose the best answer to each test question. To receive a certificate, you must receive a passing score of 80%.
  • Complete the activity evaluation and attestation.

Upon successful completion of the test, evaluation and attestation, your certificate will be processed and emailed from customerservice@sma.org within approximately 1 hour. Credits will be archived for 6 years; at any point within this time period you may login to your account to print a duplicate copy of your certificate.

Disclosure of Relevant Financial Relationships

As an organization accredited by the ACCME, Southern Medical Association requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner that could create a conflict of interest.

Southern Medical Association encourages Speakers/Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

The following individuals, unless otherwise notedhave no relevant financial relationships to disclose.

Manuscript Author(s):
Alexander Hrycko, MD
Vishal Tiwari, MD
Michael Vemula, MD
Ashley Donovan, BS
Christine Scibelli, RN
Kirti Joshi, MD
Paul Visintainer, PhD
Mihaela S. Stefan, MD, PhD

SMJ Editor-in-Chief:
G. Richard Holt, MD, MSE, MPH, MABE, D BE

Southern Medical Association/Southern Medical Journal Editorial Staff:
Jennifer S. Price, MA, Managing Editor
Anita McCabe, Copyeditor

Course Materials

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this course or view your purchase options.

Purchase this course now ($10)

Create a free account, then purchase purchase access to this course.

Purchase a membership plan (fees vary)

Premium members can access all courses plus recieve many more benefits. View all membership plans and benefit packages.