The Dugout: Reimagined Team-Based Triage in the Emergency Department

Background: Emergency department (ED) crowding is a crisis of an overstrained health care system that is associated with poor patient outcomes and dissatisfaction. We aimed to assess the effect of an interdisciplinary, provider-led triage team, “the Dugout,” on ED length of stay (LOS), door-to-provider (DTP), and left without being seen (LWBS) rates. Methods: We used a before-and-after design. The setting is an urban, teaching, adult and pediatric 63-bed emergency department with a total annual volume more than 90,000 and an admission rate of 35%. Data were collected on adult patients (18 years and older) who presented during a similar 6-month period before (October 2023–March 2024) and after (October 2024–March 2025) implementation of the Dugout. Results: There were 34,106 and 31,704 adult encounters in the pre- and postimplementation periods, respectively. The Dugout was associated with a reduction in LWBS from 14.1% to 3.0% ( p < .001). DTP decreased from a median of 59 to 38 minutes ( p < .001). The median overall ED LOS decreased from 448 to 429 minutes ( p < .001), and the LOS for discharged patients decreased from 407 to 344 minutes ( p < .001). Conclusions: The introduction of a dedicated, interdisciplinary team stationed in the triage area was associated with reduced LWBS, DTP, and ED LOS.