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Hospital Admission/Transfer to Emergency Dept.

Hospital admission

1. Protocol
   
   
   1. Provider contacts the admitting team to discuss the admission; Identify which team is accepting, will need this information for the Temporary Acute Care Admission Orders
   2. Nursing contacts census office to arrange for bed  (744-3932) and then calls the floor nurse to give report
   3. If hospital is full – it may be necessary for the provider to discuss the admission with Dr Lessler (page 663-2688); nursing will be notified when calling the census office and will advise the admitting provider
   4. Provider completes Temporary Acute Care Admission Orders unless the admitting team is or will be in clinic shortly to accept the patient
   5. If clinic is closing and bed not yet available or if patient becomes unstable then patient may need to board in the ED as a floor patient.  In this case contact the ED medicine attending (CP 744-7974) and complete the Temporary Acute Care Admission Orders.
   6. Patient is transported to the floor or ED by patient transport or clinic staff depending on the clinical situation and time of day

Transfer to the Emergency Department

1. Criteria for immediate transfer
1. Hemodynamic instability
2. Need for emergent/urgent treatment (MI, CVA)
3. Need for ICU care
4. Sepsis physiology
5. Need for close monitoring (need for cardiac monitor, unstable angina)
6. Need for urgent care not available in clinic (e.g. casting of fracture)
7. Suicidal or homicidal ideation
2. Protocol
1. Provider or attending call the ED medicine attending (CP 744-7974) or Medic One Doc.
2. Nursing call ED charge nurse (744-4025)
3. Patient is transported to the triage station within the ED (NOT to the waiting room) with appropriate monitoring
4. Depending on the situation, the STAT nurse may be called to assist in the transfer (do this by calling hospital operator 4-3000 and asking them to page)

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