Patient Admission/Discharge

PATIENT ADMISSION/DISCHARGE

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Introduction

1. PATIENT ADMISSION

Definition

Patient admission is the formal process of accepting a patient into a hospital for observation, diagnosis, treatment, or care, and allotting a bed/ward under hospital responsibility.

Objectives of Patient Admission

• To provide timely medical care

• To ensure proper identification of the patient

• To allocate appropriate bed/ward

• To maintain legal and medical records

• To ensure financial and administrative control

• To coordinate between clinical and non-clinical departments

Types of Patient Admission

1. Emergency Admission

• Sudden, life-threatening conditions

• No prior appointment

• Examples: accidents, heart attack, stroke

2. Elective (Planned) Admission

• Pre-scheduled admission

• Examples: surgery, investigations, planned therapy

3. Routine Admission

• Based on OPD consultation

• Requires doctor’s advice

4. Transfer Admission

• Patient shifted from another hospital or ward

5. Day Care Admission

• Short stay (same day discharge)

• Examples: dialysis, minor procedures

Admission Process (Step-by-Step)

1. Reception & Registration

• Patient reports to Admission Counter

• Demographic details recorded:

  • Name, age, gender

  • Address, contact

  • Aadhaar/ID proof (if applicable)

• UHID (Unique Hospital Identification Number) generated

2. Medical Assessment

• Initial assessment by doctor/nurse

• Provisional diagnosis made

• Decision for admission taken

3. Bed Allocation

• Based on:

  • Diagnosis

  • Gender

  • Paying/Non-paying category

  • Availability

• Ward/room assigned

4. Consent & Documentation

• General consent

• Treatment consent

• Surgery consent (if required)

• Insurance/TPA documents (if applicable)

5. Financial Formalities

• Advance deposit

• Insurance verification

• Package selection (if any)

6. Nursing Assessment

• Vital signs recorded

• Nursing history taken

• Patient oriented to ward rules

7. Medical Record Creation

• Case sheet opened

• Admission slip prepared

• Documents filed in MRD

Departments Involved in Admission

• Admission Office

• OPD/Emergency

• Nursing Services

• Medical Records Department (MRD)

• Accounts Department

• Insurance/TPA Desk

Legal & Administrative Importance of Admission

• Proof of hospital responsibility

• Basis for billing

• Medico-legal documentation

• Insurance claims

• Statistical data for hospital planning

2. PATIENT DISCHARGE

Definition

Patient discharge is the formal process of releasing a patient from hospital care after completion of treatment or on other authorized grounds.

Objectives of Patient Discharge

• To ensure continuity of care

• To provide clear instructions

• To settle hospital bills

• To maintain complete medical records

• To free bed for next patient

Types of Patient Discharge

1. Routine Discharge

• After successful treatment

2. Discharge on Request (DOR / LAMA)

• Patient leaves against medical advice

3. Transfer Discharge

• Shift to another hospital

4. Absconded Discharge

• Patient leaves without informing

5. Death Discharge

• After patient expiry

Discharge Process (Step-by-Step)

1. Medical Decision

• Treating doctor declares patient fit for discharge

• Discharge order written

2. Preparation of Discharge Summary

Includes:

• Patient identification details

• Date of admission & discharge

• Diagnosis

• Investigations

• Treatment given

• Condition at discharge

• Follow-up advice

• Medications

3. Billing & Clearance

• Final bill prepared

• Pharmacy, lab, OT charges added

• Insurance approval (if applicable)

• Payment clearance done

4. Nursing Discharge Procedure

• Explain medications

• Demonstrate wound care (if any)

• Return patient belongings

• Remove IV lines/catheters

5. Patient Education

• Diet instructions

• Medication schedule

• Follow-up date

• Warning signs

6. Medical Record Completion

• Discharge slip signed

• Case sheet closed

• Sent to MRD for filing

7. Bed Vacating & Housekeeping

• Bed marked vacant

• Cleaning & disinfection

• Ready for next admission

Legal Importance of Discharge

• Discharge summary is a legal document

• Used in:

  • Insurance claims

  • Court cases

  • Medical audits

• Protects hospital and doctors legally

Common Problems in Admission & Discharge

• Delay in bed allotment

• Incomplete documentation

• Billing delays

• Poor patient communication

• Insurance approval issues

Role of Hospital Administrator

• Ensure smooth patient flow

• Reduce waiting time

• Standardize SOPs

• Coordinate departments

• Monitor admission & discharge statistics

Video Description

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