Kennebec Region Health Alliance

Authors: MaineGeneral Hospitalist Team, Dr. John Smith MGMC Hospitalist Director
9/1/2014
Revised 11/19/2015, 1/27/2016

Summary: Direct admissions to the MaineGeneral hospitalist team are accepted regularly and need to be handled in a safe, efficient way. We have some guidelines that should provide guidance both to our team and to our referring physicians as to what is an appropriate direct admission.

1. If direct admission is desired, the patient must have been seen that day by the referring provider or their group. We need to be sure the patient has been evaluated and will receive the appropriate level of care upon admission. It also is helpful to have recent labs, imaging, specialty notes, or other data as appropriate. To determine what type of bed the patient will require and be certain they are stable to go to a floor bed, the admitting hospitalist needs to be contacted directly by phone and accept the direct admission based on bed availability (see contact information below).
2. If there is any question if a CCU bed will be needed, the patient should be referred to the ED. Any unstable patient should go to the ER, as a direct admission to the CCU is not allowed (unless the patient is only going there as a floor patient because other beds are not available).
3. If the patient will require urgent imaging, treatment or laboratory work (for example, time-sensitive antibiotics or urgent chest CT), they should start their evaluation in the ER as studies can be obtained much more quickly and needed therapies can be started sooner.
4. If the diagnosis is unclear it is likely safest to start the patient in the emergency department so we can try to establish a diagnosis and arrange appropriate bed placement. If there is any question if the patient actually needs to be admitted they should be evaluated in the emergency department to receive additional evaluation and studies to determine if admission is required. Lastly, the ultimate decision for direct admission falls to the admitting hospitalist.

To reach the on call hospitalist call the hospital operator 207-626-1000 and they will page the appropriate on call hospitalist.
To fax records to the hospitalist office use 207-621-7277.

Practice Guidelines and Standard Processes Disclaimer
To promote the provision of efficient and effective healthcare services, Kennebec Region Health Alliance helps develop and disseminates practice guidelines for use by its member practices. Such guidelines are based upon various sources that KRHA believes to be reliable, which may include but is not limited to, guidelines from widely recognized professional societies, boards and colleges such as the American Medical Association (AMA). Practice guidelines are reviewed at least every two years and updated as necessary to reflect changes in medical practice.
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