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    Any outpatient attending with admitting privileges can admit directly to the floor (on their service) as long as the patient has been seen within the last 24 hours.   The attending either gets in touch with our chief resident to discuss the case, or our admissions office (who contacts the chief resident).  Pre-authorization should have nothing to do with this.

    That being said, we do have some local docs who find it easier to just send the patient to the ER because it's easier than making phone calls.  We also have some clinics (Heme-Onc) who have already accessed a port, drawn bloods, and then send them to the ER to await admission/give antibiotics rather than giving the antibiotic dose in clinic.

     Streamlining the process for direct admissions results in a much happier family (No extra waiting time in a crowded ED).  There just needs to be someone on the hospital side to ensure that the patient doesn't seem likely to deteriorate before the admission happens.

Niel

RWJMS-Rutgers

________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Noah Kondamudi MD.FAAP.FACEP <[log in to unmask]>
Sent: Thursday, February 1, 2018 2:19 PM
To: [log in to unmask]
Subject: Direct inpatient Admit bypassing ED

Does anyone have a mapped process for patients needing in-patient care from clinics/offices/urgent care centers that bypass ED registration and evaluation. It appears that patients are sent to ED for admission although the decision already made by the providers presumably to avoid pre-authorization. Do they always need pre-authorizaion.
Please feel free to reply me offline at [log in to unmask]

Noah Kondamudi MD. MBA
Chair, Department of Pediatrics
The Brooklyn Hospital Center

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