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Admissions Management: Academic MultiTeam / EC / Bed Control / EMR

  • 1.  Admissions Management: Academic MultiTeam / EC / Bed Control / EMR

    Posted 01-11-2021 14:43
    Happy New Year!
    I'm posting on the main forum as I could not decide which group was best.  Also very long post!
    ??:  How do you handle the coordination between the EC / Bed Control / Multiple Teams & the EMR in an Academic environment?

    Background: (team names changed, in reality, named after a bunch of retired old faculty dudes)
    We have the team system for our patients/residents/faculty across Inpt AND Outpatient.  The patients are assigned to one of the three teams, and residents and faculty are split among the teams.  This means that a Rockets team patient sees a Rockets team resident in Clinic, supervised by a Rockets team faculty.  If admitted to Rockets team, discharged to follow up in Rockets team clinic. Patients identify more with their team than the individual faculty.
    When this patient needs to be admitted to the hospital from the EC, the EC attending calls bed control and tells them that they have a Rockets team patient needing admission.  The Rockets team attending is paged and accepts the admission after talking to the EC Attending, then the Rockets team Attending places an order in EPIC to "admit to Rockets team" which is basically an order to let bed control know we need a bed on the Rockets ward (Geographic rounding).  We do the same for Texans team and Astros teams. 
    If Astros is capped, the Astros attending tells bed control they are capped, and bed control then directs the page to the overflow team: "Dynamos"
    We do NOT have a non-teaching service.

    The hospital and bed control are tired of trying to figure out which team a patient needs to go to.  They just want to say, "admit to medicine", at which point the Epic EMR smart bed control program will assign a bed to a patient automatically.  Basically, they want us to be like orthopedics or general surgery. One team in Epic's eyes that takes all patients, and there is NO further complexity.

    In a same service, but multi team environment, how do you all manage the interplay between EC / bed control / and team placement?  We could assign a resident to do this task, but there is no educational value in it, not to mention mind numbing where we are seeing around 20 to 30 admissions per 24 period across all 4 teams.  We want to avoid this as much as possible.
    Do you use a Utilization Review team at time of admission? Hospitalist? Outsourced?

    Sunil Sahai
    Division Chief, General Medicine
    University of Texas Medical Branch School of Medicine
    Galveston TX
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