Providing a Clear Path to the Direct Admission Process

Area of Science:

• Healthcare quality improvement
• Patient safety protocols
• Clinical informatics

Background:

• Direct hospital admissions without clinical triage pose significant patient safety risks.
• Ineffective triage can lead to inappropriate patient placement and adverse events.

Purpose of the Study:

• To enhance patient safety during care transitions.
• To develop and implement a novel electronic screening tool for direct admissions.

Main Methods:

• An electronic medical record module using the Situation, Background, Assessment, and Recommendation (SBAR) mnemonic was developed.
• Transfer center nurses utilized the module for clinical triage and bed placement of direct admission requests.

Main Results:

• 189 direct admissions were evaluated; 13 patients were screened and redirected to the emergency department due to instability.
• One safety event occurred involving a hypoglycemic patient post-admission.
• The new screening program demonstrated a safer approach to direct patient admissions.

Conclusions:

• The electronic SBAR tool facilitates compliance with Joint Commission standards for care transitions.
• Workflow modifications significantly improved patient safety.
• The program's success warrants future expansion to all hospital service lines.