Guidelines for Direct Admission of Patients from Clinic Or Home

3-12-09

Guidelines for direct admission of patients from clinic or home

 If a UNC physician wants to request a bed for a patient who is in clinic or at home for the same day or as an urgent admission, he/she should call the upper level resident on the appropriate service.

 Identification of and contact information for the appropriate resident can be found by going to amion.com and typing in password “uncmed”. Off this page you will see all the on-call residents and pager numbers for each service. In addition, the night float residents who come on at 7pm are listed with contact information.

 In speaking with the upper level resident, please be cognizant that it is possible the requested team may cap before your patient gets a bed in which case that patient would likely be admitted and floated to the on-call team for the following day. Issues have arisen from referring physicians regarding communicating with the “correct” resident if that patient does not arrive before the on-call team caps. We ask that our residents document on webcis any information they receive from a referring physician and document whether it is okay to call that referring physician with questions should they arise once the patient arrives on the floor. In addition, if a referring physician finds that his/her patient has not gotten a bed or the referral is made later in the day, then use of amion.com to identify and communicate with the night float resident at 7pm is another potential helpful option.

 The referring UNC physician, after speaking with the on service resident, should then call 6-2041 option #2 and give all of the information to the RN who will then create a case in A2K. This case will alert Bed Assignment that a patient is waiting for a bed.

 If the patient is well enough to go to Admitting, he/she should go there. If there is no bed available on the floor or in the Admitting-Discharge Unit (ADU), the patient can give a number where he/she can be reached and the admitting staff will call the patient when the bed is available if he/she is well enough to wait at home.

 If the patient is in clinic and is too sick to go to Admitting but does not need to go to the ED, the referring physician can call the Nursing Supervisor (pager 347-1922) to let her know there is a patient in clinic in need of a bed. These patients will be assigned a bed over a patient of similar acuity in the ED.