Admitting A Patient

When decision to admit the patient has been reached, click on dashboard admission link

Follow the admitting prompts to submit an electronic bed request to start the admission process. See the Admission Process page to read the admission primer, which helps you determine who to admit to. The instructions below show how to physically admit the patient using the dashboard.

Bed Request

After the bed is requested a yellow “R” will appear on the patient tracking screen

Once a bed is assigned, the yellow “R” on the dashboard will turn into a green “A”

  • Perform a STOP with the nursing staff to review patient care and any remaining issues, tests, medications or procedures needed before admission If admitting to medicine you will now send an “e-signout” electronically to the team (covered below) After e-signout is complete with the medicine service, you will need to write holding orders through the Main-POE prompt

If admitting to a surgical service or neurology then e-signout is not available and the admitting service is responsible for writing admission orders. The goal for time from bed assignment to admission is 90 minutes. After 90 minutes the green “A” will become a red “A”. Red “A”s may be retrospectively examined to determine causes for significant delays in admission

If a delay in admission has resulted from a specific cause that should be addressed by the ED administration, flag the case under the “Red A” tab of the flagging system

PCPs should be contacted to inform them about the admission. Some PCPs do not want be called about admissions and this is noted on the dashboard.

Bed Assigned - E-Signout Procedure

Electronic signout is available for medicine admissions (except for the ICU). That means that, after the bed has been assigned (green “A”), the e-signout should be sent to the admitting team. The team will read the MD comments and electronically accept the patient without the need for a phone call.

Perform a STOP with the nursing staff to review patient care and any remaining issues, tests, medications or procedures needed before admission

Click link to send e-signout to admitting team

Admitting team will review dashboard and can do one of two things:

- Accept patient

- Initiate MD verbal discussion if needed

Accepted patient will result in Green MD box

MD verbal discussion will result in Red MD box. ED team will then contact admitting team to discuss questions or concerns

Holding orders should be written after patient has been accepted by admitting team

Follow prompts in Main-POE to enter holding orders

After holding orders have been entered a black border will appear around the green “A” signifying the patient is ready to be moved to the inpatient bed

ED nurses will complete RN e-signout with floor nursing team and unit clerks will arrange for transport of patient from ED to inpatient bed

  • Holding orders indicate that the patient is ready to be taken to the inpatient room assigned

  • If any part of the e-signout process has not been completed, DO NOT write holding orders as this will result in the patient being taken upstairs before the transition of care has been completed

  • If the patient is changed from floor to ICU, or vice versa, then any holding orders must be cancelled in the Main-POE or the ED dashboard will inappropriately indicate that the signout has been completed for the new bed assigned