                                                     
  ---------- --------------------------------- ----------------------- ---------------------- ----------------------- ------------------------
  0%         100.5 (97--104)^a,A,G1^           94 (87--100)^ab,A,G3^   87 (86--91)^bc,A,G4^   90 (79--92)^bc,AB,G5^   86 (77--88)^c,AB,G6^
  0.018%     41.5 (36--43.5)^a,B,G2^           57 (52--60)^b,B,G7^     68 (64--73)^bc,B,G8^   75 (67--84)^c,A,G9^     72.5 (69--78)^c,A,G10^

Lowercase letters permit comparisons within rows while uppercase letters permit comparisons within columns. Groups identified with the same letters do not differ significantly (Mann-Whitney test, *P* \> 0.05).

[^1]: Academic Editor: Maha Zaki Rizk


INTRODUCTION
============

Emergency department (ED) visits have steadily increased over the last decade, outpacing population growth.[@b1-wjem-21-647],[@b2-wjem-21-647] As ED utilization has increased, boarding of admitted patients in the ED while they await inpatient bed assignment has become a nationally ubiquitous issue.[@b3-wjem-21-647]--[@b5-wjem-21-647] In 2014, Pitts *et al.* found the national median boarding time was 79 minutes with 32% of admitted patients waiting greater than two hours for bed assignment.[@b6-wjem-21-647] Among other adverse effects, boarded patients are less likely to have inpatient care initiated and boarding is associated with increased mortality.[@b3-wjem-21-647],[@b4-wjem-21-647],[@b7-wjem-21-647]

The physician-in-triage (PIT) intake model has been shown to improve ED operational efficiency in both community EDs and tertiary referral centers.[@b8-wjem-21-647]--[@b12-wjem-21-647] Specifically, PIT is associated with improved intake (shorter door to provider times and lower left without being seen rates) and throughput (shorter lengths-of-stay), as well as other ED measures of efficiency (fewer days of ambulance diversion and shorter radiologic turnaround times).[@b8-wjem-21-647]--[@b13-wjem-21-647]

PIT models are designed to improve ED intake and throughput. The e