Providing a Clear Path to the Direct Admission Process

The aim of this study was to increase patient safety during care transitions through the development of a new process and electronic screening tool.

Direct hospital admissions that are not clinically triaged can put the patient at an increased safety risk.

Utilizing the electronic medical record and mnemonic situation, background, assessment, and recommendation (SBAR), an admission module was created to intake direct admission requests by transfer center nurses to ensure clinical triage and accurate bed placement.

One hundred eighty-nine direct admissions met inclusion criteria. Thirteen patients were clinically screened, deemed not stable for the acute care setting, and sent to the emergency department. One direct admission safety event occurred involving a hypoglycemic patient upon arrival. Results indicate the new clinical screening program offered a safer way to directly admit patients to the inpatient setting.

Implementation of the electronic SBAR handoff tool meets the Joint Commission standard of care transitions compliance. The significant workflow changes increased patient safety and will be expanded in the future to all service lines.