Floor Admission Guidelines

• Yellow: J10 beds + CDU + J12S PHM + J12N + J7 

• Orange:  J11 beds + CDU + J12S PHM + J12N + J7

• Red: 

  • • any Heme/Onc patient on any floor (even COVID-19 +), any Endocrine or Nephrology service patients on any floor including bed holds for these teams

Non Red-team Bed Holds & Overflow Unit Patients (including J12N/CDU/J7 or any other floor not accounted for above) - to be determined by census between Yellow and Orange. Transfer center will call & the senior will act as an admitting officer, choosing team based on census & work-load distribution. You can page the chiefs day or night for any clarity 

Overflow units: (coverage as of 25/26 AY) - PHM has approved

• CDU: orange or yellow, will serve as "balancing" floor

• J12N: orange or yellow, will serve as "balancing" floor 

• J7: orange or yellow, will serve as "balancing" floor

Extra, extra overflow (may also be split depending on census)

• PACU: orange/yellow

• OVA: orange/yellow

• NICU Overflow: orange/yellow

• Chief Admissions:  

  • July - January:  Chiefs will admit floor patients from the ED 7:45AM to 11AM (only if still rounding)

  • January - June: Chiefs to help supervise and teach; floor intern who will be carrying the patient to do abbreviated admission 

  • Direct admissions and PICU transfers during rounds will be handled by floor teams

  • Chiefs may be unavailable to always do admissions but we are happy to help when we can!  
    
    

Floor Interns: 

• Please update the boards in all patient rooms with the correct ASCOM # for nurses to call *especially in the PACU, J7, CDU, and J12N! 

• Please make sure your patients are listed under the correct attending and service in powerchart (especially for new admits and PICU/NICU transfers) - "transfer of service" and "transfer of attending" orders

• Night team: prepare 8 am discharge paperwork

Floor Seniors: 

• If you get a call about an admission that is not yours, accept the bed from transfer center and contact appropriate floor senior!

• Day Team --> Please notify PHM on-call DAY attending of any new admissions after rounds until 4pm 

• Night Team --> Prepare a succinct list of patients ready for 8am discharge - communicate to night-call attending during AM check-in ~5:30-6:30AM. J12 senior proactively reach out to PHS attending (by cortext). Update respective charge nurses. *If hospital is getting to overflow/surge status overnight (CDU full, J12 north full, ED bed holds backing up) please page the chiefs around 5am.

Attendings: 

•  Attendings will examine the discharge patients on their own before 8am, to the best of their ability.  Once rounds start, attendings not actively rounding will continue to work on their discharges. 

• While attendings examine the discharge patients and “clear” them, interns work on the paperwork.   No need to formally present/round on. 

• For the remainder of rounds:  overnights (and sick kids) and then normal rounds.  Plan to discharge any further discharge-ready kids right on rounds when possible; please have prepped, as best as possible, ahead of time. 

Transferring Patients (esp from NICU/PICU): 

ICU residents:  CONFIRM which floor the patient is going to before giving sign-out

Floor residents: if you receive a sign-out and the patient does not arrive to your floor by the end of your shift, please call the transferring service back and check on the patient!

Private Attending List - Do NOT admit to PHM!
Last Updated 07/07/2025

All of these attendings must be notified about admissions from the ED, NICU or PICU and need to accept the patient to their service prior to them going to the floor.

To find out a patient's PMD: click on patient information tab on power chart (bottom left), PPR summary tab, look for "active" primary pediatrician

• Holiday Pediatrics (Dejneka) [PHS will cover if his office states he’s on vacation]

• Jericho Road Family Practice (Burdo, Edwards, Glick, Harding, Henke, Krol, Krolikowski, Milazzo, Maran, Stoltzfus)

  • All lead chelation patients go to Jericho Road service, regardless of PMD

• UBMD Med-Peds including Evergreen Health (Abeles, Aronica, Blymire, Gosine, Padgett, Sulaiman, Zambron)

• Maple Med-Peds admits to UBMD Med Peds:  (Bohince, Boice, Hartrich, Heyden, Riedy, Thierman)

• If a private patient has been found to be accidentally under the care of the J10 team, then the J10 team can continue taking care of that patient. The J10 team will need to contact the private attending daily for updates.

Admitting to Pediatric Subspecialty Services

• Adolescent: No longer has an admitting service as of 11/18/23.  Admit to PHM with Adolescent consult. 

• A/I:

  • FPIES challenges

• Endocrine:

  • Diabetes, panhypopituitarism, hypocalcemia

  • **when above problem is the primary reason for admission**

• GI:

  • Gelfond/Hashmi/Nugent group admits their patients for exacerbations of their known GI disorders

  • UBMD GI patients go to PHM or appropriate private PMD service

• Hem/Onc: Admit to J12S when able with negative COVID. 

  • Cancer, Sickle Cell, Hemophilia, new solid mass, severe anemia, hemolytic anemia, severe pancytopenia, DVT/PE, Thalassemia Major

• ID:

  • Known HIV positive - discuss with attending first. 

  • Tropical Infectious diseases on case-by-case basis

• Nephro:

  • Dialysis patients

  • Nephrotic Syndrome

  • Other acute kidney failure (when this is the primary issue)

• Neuro: no longer has a private service.  Admit to PHM with neuro consult. 

  • Exacerbation of known seizure disorder, age > 12 months (< 12 months per neuro attending discretion)

    • No comorbid infectious disease or other significant medical problem (eg: trach)

    • DENT patients will typically go to PHM

  • Acute or exacerbated neurological conditions such as Guillain Barre, ADEM, transverse myelitis

• Pulm:

  • CF

• Rheum:

  • Exacerbation of known Rheum disorder

Pediatric Medicine Consults

• • If you get a called about a pediatric medicine consult, the senior covering the floor that the patient needing a consult is on, takes the consult. 

  • See the patient, develop your assessment and plan and then discuss with the appropriate attending (PHS or private)

  • Consult for patient on J10  = yellow senior 

  • Consult for patient on J11, CDU, J12N, & ED OV =  orange senior 

  • Consult for patient on J12S or ED bed hold = red senior

  • Make sure to check if the patient sees one of the private attendings as their PMD prior to notifying the on-call PHS attending of the consult.