Feasibility and early outcomes of a multi-site TeleHospitalist admissions programme: staff and patient perspectives from a large health system

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: 86% staff favour continuation, 79% comfortable with technology

• Primary Outcome: Programme feasibility with 1575 completed TeleHospitalist encounters

• Nnt Or Sensitivity: Median ED arrival-to-admission time 7.3 hours (IQR 4.7-12.8), median LOS 38.5 hours (IQR 17.3-66.3)

• Confidence Interval: Not reported

Clinical Application

Appears feasible in large health systems with established telemedicine infrastructure Relevant to Australian hospitals facing similar staffing shortages, though would require adaptation to local workflows and TGA-approved telemedicine platforms Adult patients requiring hospital admission, particularly in settings with nocturnal staffing challenges

Abstract

BACKGROUND: Staffing shortages contribute to admission delays, fragmented care and hospitalist burnout. Although telemedicine has been widely adopted in critical care and subspecialties, its use in general inpatient admissions remains understudied. This study evaluated the feasibility, operational performance and early perceptions of a TeleHospitalist admissions programme designed to address nocturnal staffing shortages in a large academic health system. METHODS: In October 2024, Houston Methodist launched a nocturnal TeleHospitalist programme. The programme provided centralised coverage via audio-video technology, operating from 18:00 to 02:00 initially and expanding to 18:00-06:00. Adult patients admitted from the emergency department (ED) between October 2024 and August 2025 and clinical staff involved in admission workflows, were surveyed. Operational data on admission timeliness were extracted from the Epic electronic medical record, and patient and staff experiences were evaluated through structured surveys and qualitative feedback. RESULTS: Over 10 months, 1575 TeleHospitalist encounters were completed (median age 65 years (IQR 49 to 75); 56% were ≥65 years). Median hospital length of stay was 38.5 hours (IQR 17.3 to 66.3), and median ED arrival-to-admission time was 7.3 hours (IQR 4.7 to 12.8). Among 311 patient respondents (19.7%; median age 66.5 years (IQR 52.3 to 75.6); 5% were ≥65 years), satisfaction scores were high (median 4 (IQR 3 to 5). Staff responses (n=29) demonstrated strong endorsement: 86% favoured continuation, 79% reported comfort with the technology and 75% rated admission processes as better than traditional workflows. CONCLUSIONS: A system-wide TeleHospitalist admissions programme was feasible and well accepted by patients and staff. Older adults reported positive experiences, suggesting age is not a barrier to virtual inpatient care. Early findings indicate improved timeliness, communication and workflow efficiency while mitigating overnight staffing gaps. Future studies will evaluate long-term outcomes, cost-effectiveness and strategies to enhance privacy and patient engagement.

References

1. 1.Nguyen, N., Sossong, S., Ishaq, F., Ellison, H., Lee, G., Randle, L., Gomez, M., Machnik, J., & Pletcher, S. (2026). Feasibility and early outcomes of a multi-site TeleHospitalist admissions programme: staff and patient perspectives from a large health system. BMJ Open Quality. https://doi.org/10.1136/bmjoq-2025-003963