Steps Hospitalists Should Take to Reduce Turnaround Time of Death Certificates

Follow up on Direct Admissions

In the April 2013 issue, I wrote about the challenges associated with direct admissions (“Hospitalist Workload,” p. 69). I heard from a number of people, including Dr. Rob Young, a talented hospitalist who pointed me to a paper by his colleagues at Northwestern University (Am J Emerg Med. 2012;30(3):432-439). It makes sense that the safety of direct admission is influenced by the patient’s diagnosis, and sepsis patients are safer stopping in the ED first. And it can be tricky to sort all of this out in advance.

Dr. Mujtaba Ali-Khan, a hospitalist practicing in the Houston area, made me aware of the Direct Admission System for Hospitals (DASH), a commercial product he and a colleague have developed. I don’t have any experience with it and so can’t comment on its value, but you can learn more for yourself on YouTube (http://www.youtube.com/watch?v=HUG_vQgKvE0). What a clever idea for them to create a hospital “boarding pass” that the direct-admission patient presents on arrival to the hospital.

—John Nelson, MD, MHM