Physicians with privileges at Dayton Children’s may direct admit their patient to an inpatient unit to receive specialized care. This direct admission process speeds the admission process for patients and enables the patient to receive that care without an emergency department visit and evaluation. To direct admit a patient, the patient must have been seen by the referring physician within 12 hours if admitted to an inpatient unit and within 24 hours if admitted for observation in our Almost Home Unit. Further, if the patient’s condition requires a more complex work-up or order and/or significant stabilization is required, the patient should be admitted through the emergency department for the safety of the patient.
The direct admit process
1. Primary care physician sees patient in the office and determines in-hospital management is required and a direct admission may be appropriate. (The patient’s condition does not require a complex order and the patient does not require significant stabilization.)
2.Primary care physician calls the communications center at Dayton Children’s at (937) 641-4385 to start the direct admission process. The communications center will ask for the following information:
- Patient’s name and date of birth
- The referring physicians direct contact phone number
3. The communication center connects the primary care physician with the admitting resident. (If the admitting resident does not answer within a few minutes, the communication center locates the admitting resident and has him/her call back the PCP immediately.)
4. The PCP and the admitting resident discuss the patient’s condition and determine the appropriate admission-- inpatient, asthma care or observation. If the admitting resident is concerned about the patient’s condition or the need for more extensive initial work-up, the resident will advise against a direct admit and may consult with the attending inpatient general pediatrician if needed.
5. The PCP writes initial orders and faxes them to admitting at 937-641-3326. PCP must use the direct admit order set. If the diagnosis is hyperbilirubinemia, the PCP completes order designated for that condition. These order sets are available at www.childrensdayton.org/cms/provider.
6. The PCP prints and completes the parent instruction form and reviews the special instructions with the parents.
Communication with family
For the patient’s safety, the primary care physician needs to advise the family of the following:
- Arrive at Dayton Children’s within three hours of the office visit or the decision to direct admit.
- Follow any instructions you provide about eating or drinking before arriving at Dayton Children’s.
- Bring the child’s list of medications.
Please remind the child’s family to bring their insurance information with them and be sure to reinforce that if they do not arrive within the specified timeframe, the child will need to be evaluated in the emergency department before he can be directly admitted.
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