Types of Hospital Admissions

From emergency admissions for critical cases to planned patient admissions for surgeries or treatments, understanding the various types of hospital admissions is essential for both patients and their families. 

Learn about the diverse scenarios that lead to a patient admitted in hospital, and how each type of admission caters to their specific needs and medical requirements in this blog.

Types of Hospital Admissions

Hospital admission and discharge depend on personal circumstances and the seriousness of the injury or illness. Here are the two main types of hospital admissions: emergency admission in hospital for critical cases, and elective admission or routine admission in hospital for planned surgeries or treatments.

Some patients, for example, patients requiring chemotherapy who are both urgent and planned, may confuse these concepts. 

The establishment of an efficient emergency and elective admissions and discharge planning function should be guided by many concepts. 

These are some of them: 

• The delivery of patient-centered services to the right people in the right place at the right time without jeopardizing safety, quality, or clinical standards to the general public. 
• Patients should be consulted and included in all healthcare choices. 
• The most recent evidence should be used to guide clinical practice and care. 
• Collaboration and clinical networking across hospitals and care groups are critical to improving outcomes, especially when dealing with complicated medical challenges. 
• A service that is based on sound clinical judgment (i.e., founded on continuous quality improvement, staff development, risk management, and audit) 
• Acute hospital services should be divided into three interdependent streams of care. They are divided into three categories: emergency, elective, and outpatient/daycare. 
• The importance of Primary Care Teams should be highlighted. 
• Healthcare staff should receive early introduction training by the principles outlined above. 

Proper management of hospital beds and associated resources is critical if the increasing demand for hospital resources is to be satisfied. 

The following are examples of known barriers to the patient "flow" in hospitals: 

• Access to inpatient beds is difficult to come by (i.e. insufficient bed capacity) 
• As a result, Emergency Departments are overburdened. 
• Patients should not be kept in hospital beds for long periods. 

Resources must be used efficiently and effectively to ensure that all patients admitted to the hospital receive the high-quality and safe care to which they are entitled. 

Patients can transition effortlessly between emergency care and the best and most suitable inpatient care, primary care, and ongoing care, depending on their needs. All users of health services have the right to effective quality assurance and safe care.

Emergency Admissions 

An unplanned emergency hospital admission occurs as a result of trauma (injury) or an acute illness that cannot be handled as an outpatient. 

The criteria listed below have been discovered as useful in enhancing admissions management and general patient flow in the Emergency Department to manage the balance between elective and emergency admissions. 

• In the emergency department (ED), immediate care takes precedence over conventional admission processes. 
• The patient is given a temporary identification bracelet, a physician's order sheet, and a record of care when they arrive at the nursing unit after ED treatment. 
• To maintain continuity of treatment and obtain insight into the patient's condition and behavior, read this record and speak with the nurse who cared for the patient in the ED. 
• Next, make a note of any ongoing treatments, such as an IV infusion. Take and record the patient's vital signs, and treat the patient according to the doctor's recommendations. 
• If the patient has family members with them, ask them to wait in the lounge while you assess the situation and begin the treatment. 
• After the patient has settled into their room, allow them to see them. 
• Start with normal admission procedures as soon as the patient's condition allows. 

Elective Admissions 

Keeping the competing demands for hospital beds from elective and emergency cases of various complexity in check will undoubtedly remain a significant concern in the future. The following priorities have been highlighted to improve the experience of patients waiting for elective admission: 

• On the ratio of emergency admissions to planned elective surgeries, there is a local clinical consensus. 
• Criteria for hospital admission and periods of stay are being reviewed and monitored. 
• Greater emphasis on ensuring that when admitting elective patients, the length of time they have been waiting since the decision to admit was made – taking into account their clinical needs – is taken into account. 
• Greater consistency in waiting list administration, including regular monitoring of cancellations, suspensions, and removal from waiting lists without treatment. 
• The focus is on discharge planning from the first day of hospitalization. 
• The implementation of a holistic approach to bed management 
• The appointment of a management or clinician with enough authority and support to balance and monitor the opposing demands of emergency and elective pressures, ensuring that all bed and theater resources are fully utilized. 

Before a patient is admitted to the hospital, it's essential to plan their entire care journey, involving patients and caregivers in the process. A Hospital Bed Manager oversees bed management and coordinates the team responsible for implementing the policy. This service operates 24/7, ensuring effective management. If you're wondering how to get admitted to the hospital overnight, understanding these procedures is crucial.

A senior member of management reports to the bed manager. Continuous analysis and the giving of reports and projections would be part of their responsibilities. The responsibility for allocating beds to patients should be centralized, and the Hospital Bed Manager should have full control over all hospital beds. The bed designation ratio established by the Department of Health and Children should be understood. The Hospital Bed Manager should work within the notional allocation of beds to each specialty to ensure that patients are placed in the most appropriate bed available at the time of their admission and that patients are cared for by staff with the necessary skills. 

The following critical requirements have been identified to promote efficient optional admission methods: 

• Clinical consensus on the parameters for scheduling theater lists and centralized waiting list management 
• All elective admissions should have a pre-admission assessment as a regular requirement to ensure proper planning of the patient's complete trip. 
• For elective admissions, the anticipated length of stay (which should be stated as soon as possible to aid scheduling) should be indicated as soon as possible to facilitate scheduling. 
• Increased day surgery can also be aided by a pre-admission assessment to guarantee proper scheduling and reduce in-patient bed transfers. 

What after being admitted to the hospital?

Once a patient has received initial care and been admitted to the hospital, their specific situation will determine the department they're assigned to. 

Here's what patients can anticipate after:

Providing basic supplies during the hospital stay

When patients are in the hospital, it's important to ensure their comfort by offering basic amenities. Here are some items that hospitals either provide or offer for purchase:

• Socks
• Pillows
• Blankets
• Food and beverages
• Women's health supplies
• Toiletries
• Sanitary items
• Access to bathrooms

Patients who aren't admitted as emergencies have the opportunity to pack personal items like pajamas, etc. to make their stay more comfortable.

Sharing room arrangements

While some hospitals offer private rooms, they are usually reserved for patients with contagious illnesses. 

In most cases, patients will be placed in shared rooms separated by curtains for privacy and to make efficient use of space.

Interacting with Healthcare Professionals

After being admitted, patients can expect to be attended by various healthcare professionals, including nurses, nurse practitioners, student nurses, nursing assistants, physicians, and specialists. 

Patients might also encounter non-clinical staff like lab technicians, therapists, and dietitians. Healthcare staff will introduce themselves and explain their purpose when entering the room, and patients are encouraged to ask questions or request specific providers if needed.

Conducting Medical Tests

Performing medical tests is crucial for diagnosing patients accurately and planning their treatment. Tests can range from basic blood and urine samples to more advanced procedures like CT scans or ultrasounds. 

Healthcare professionals always communicate with patients about the purpose and necessity of each test, ensuring that patients understand the reasons behind them.

Special Diet

Patients' diets play a significant role in their health, and certain foods can worsen their conditions. 

To address this, hospitals often implement restricted diets for patients with specific health concerns. Those with conditions like food allergies, gluten intolerance, digestive problems, Crohn’s disease, and diabetes benefit from such diets. 

Moreover, patients who have recently had surgery are given clear liquids and easily digestible foods. Healthcare providers ensure that patients understand and follow these dietary restrictions to promote their well-being.

Comfort During Hospital Stay

Patients often experience sleep difficulties in hospitals, as the environment is unfamiliar and interruptions are common. On average, patients sleep about two hours less than they do at home. 

To improve sleep, patients can take measures to reduce sensory disturbances. Using an eye mask to block light and earplugs or noise-canceling headphones to minimize noise can help. 

Additionally, bringing comfortable blankets and pillows from home can enhance overall comfort and rest during the hospital stay.

Questions regarding Ongoing Treatment

Patients may encounter medical terminology and abbreviations used by healthcare providers, leading to confusion or feeling left out. However, patients should feel empowered to ask questions at any stage of their treatment. Patients can inquire about their treatment details, potential alternatives, and how it aligns with their overall health condition. 

If a treatment clashes with an existing medical issue, patients have the right to discuss alternatives or adjustments to ensure their well-being. Patient involvement in treatment decisions is encouraged.

Hospital Discharge

When a patient is ready to leave the hospital, it's known as a hospital discharge. This happens when the patient is well enough to go back home or to a care facility. During discharge, the patient gets paperwork that includes:

• Reasons for the hospital admission
• Diagnosis and any important findings
• Summary of the hospital stay
• Current medical condition at discharge
• Detailed discharge plan
• Doctor's signature

The discharge plan is crucial for patients and caregivers to understand. Even though leaving the hospital means improvement, not following the plan might lead to rehospitalization. 

The plan includes:

• Patient's health details (including allergies)
• List of medicines with instructions
• Wound care information (if needed)
• Follow-up appointment dates and contacts
• Emergency contacts and general inquiries
• Diet instructions (if needed)
• Guidelines for activity levels

Patient's Rights During Hospital Stay

When someone is in the hospital, they might feel overwhelmed, but it's important to know they have rights that ensure they're treated well. 

Here are the rights patients have while receiving medical care:

• Respectful Treatment: Patients, no matter who they are, deserve to be treated respectfully by their healthcare providers.
• Access to Medical Records: Patients have the legal right to see their medical records, including test results and notes.
• Medical Record Privacy: Even healthcare providers who've seen the records before can't share them without permission.
• Choosing Treatment: Doctors suggest treatment, but patients can choose differently if they're fully aware and clear-minded.
• Informed Consent: Patients get information about their condition and treatment options so they can make informed decisions. They sign a paper to show they understand.
• Refusing Treatment: Patients can refuse treatment, whether it's medication, vaccinations, or procedures, due to personal, religious, or other reasons.
• End-of-Life Choices: Patients can plan ahead for their end-of-life wishes. They can appoint someone to make medical decisions and create a living will that outlines their preferences for treatment in different situations.

Knowing these rights helps patients feel empowered and involved in their care.

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FAQs

1. What is the most common hospital admission?

The most common hospital admission is an elective admission for routine medical procedures and planned treatments.

2. What is a planned admission to a hospital?

A planned admission to a hospital refers to a pre-arranged entry for a patient to receive scheduled medical treatment, procedure, or surgery.

3. What are the reasons for admitting a patient?

Patients are admitted to a hospital for various reasons, including medical treatment, surgical procedures, diagnostic tests, specialized care, and management of severe illnesses or injuries that require continuous monitoring and medical treatment.

4. What should patients do if they require an elective admission?

If patients require an elective admission to the hospital, they should consult with their healthcare provider or specialist, who will assess their medical condition, recommend the appropriate treatment or procedure, and coordinate the admission process with the hospital's administrative team.

5. What are the fundamental procedures when admitting a patient?

The fundamental procedures when admitting a patient typically involve completing the necessary paperwork, verifying personal and medical information, conducting initial assessments, and assigning a hospital room or bed.