Admit Workflow

1. Update Patient Problem List (if needed)

2. Add Relevant Hospital Diagnoses and Assign a Principal Diagnosis

TIP

Assigning a Principal Diagnosis populates numerous helpful EPIC fields.

3. Perform Admission Order Reconciliation

Pharmacy generally performs the review of home medications but this may be delayed at night.

1. Perform home medication reconciliation

• Mark Order for meds you want continued
• Mark Don't Order for meds that need to be stopped are or are unimportant (e.g. supplements)
• Mark Order and Hold for meds that need to be held a day or two
  

2. Reconcile ER Orders

NOTE

✅ Continue: Labs, Imaging, one-time meds, and EKGs
⛔️ Discontinue: ER Telemetry/Continuous Oximetry, Nursing orders, and other no longer needed orders

3. Complete Admission Order Set: General Admission or ICU Admission

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4. Add Other Order Sets

IMPORTANT

For time sensitive and urgent orders, be sure to order from the “Orders” tab. Orders from the “Orders” tab are released immediately. Orders placed in the “Admission” tab, as shown above, are Held until released by nursing which can take several hours. Only basic orders should be placed in the Admit Order set.

5. Write Admission H&P Note

There are several H&P templates available if you do not already have one

Admission H&P Notes

Dot Phrase	Author/Maintainer
.RDSHISTORYANDPYSICAL	Dr. Smith
.AACHANDP	Dr. Coggins
.SPHADMISSIONNOTE

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Dr. Smith’s Common Admission Diagnoses

Dot Phrase	Notes
.RDSALCOHOLWITHDRAWAL	Alcohol Withdrawal management plan with options for Ativan and Phenobarbital
.RDSCAP	Pneumonia managment plan
.RDSCHESTPAIN	Unstable angina and chest pain rule out management plan
.RDSCHFEXACERBATION	Decompensated heart failure management plan
.RDSCOPD	COPD and Asthma exacerbation management plan
.RDSCOVID	COVID infection hospitalization plan
.RDSCVA	Stroke management plan
.RDSDKA	DKA (Diabetic Ketoacidosis) management plan
.RDSGIBLEED	GI Bleed (Upper and Lower) management plan
.RDSNSTEMI	NSTEMI management plan
.RDSSEPSIS	Sepsis and severe sepsis management plan
.RDSSEPTICSHOCK	Septic Shock management plan with sepsis exam reminder

TIP

These management plans are meant as suggested checklists, not strict guidelines. Delete and edit areas that are not needed for your particular situation.

Link to original