Admission

Captures comprehensive details of a patient's admission to a healthcare facility for inpatient care. Tracks admission source, bed assignments, dietary requirements, and special arrangements for resource allocation and care coordination.

Overview

Admission extends Encounter with inpatient-specific details when a patient is admitted for overnight stay. It records how the patient arrived (emergency, transfer, scheduled), where they came from, their bed assignment, dietary requirements, and any special accommodations needed. The Admission entity is paired with Discharge to bookend the inpatient episode.

Key Concepts

Admission Sources

How the patient entered the facility:

Pre-Admission Process

The preAdmissionIdentifier tracks patients through the pre-admission workflow:

• Registration before arrival
• Pre-operative testing
• Insurance verification
• Room/bed reservation

Transfer Tracking

The origin field captures the source facility when patient is transferred:

• Hospital-to-hospital transfers
• Nursing home to hospital
• Rehabilitation facility transfers

Bed Management

Bed assignments are tracked at admission:

• destination - Initial department/ward
• room - Room number
• bed - Specific bed identifier

Subsequent moves are tracked via EncounterLocation.

Dietary Requirements

The dietPreferences array links to HealthReferenceDietaryRegime:

• Medical diets (diabetic, cardiac, renal)
• Allergy-based restrictions
• Religious/cultural preferences
• NPO for surgery

Special Arrangements

The specialArrangement array captures accommodation needs:

• Wheelchair accessibility
• Interpreter services
• Oxygen support
• Cardiac monitoring
• Isolation precautions

Readmission Tracking

The reAdmission flag indicates if this is a return admission:

• Important for quality metrics
• May trigger different clinical pathways
• Affects reimbursement

Use Cases

Emergency Admission

When admitting from ED:

1. Create admission with admitSource: "emergency"
2. Link to originating ED encounter via partOf
3. Assign initial bed and department
4. Document admitting practitioner
5. Set dietary and special needs

Scheduled Admission

For planned procedures:

1. Use preAdmissionIdentifier from registration
2. Set admitSource: "routine"
3. Assign reserved bed
4. Apply pre-operative diet (often NPO)
5. Document expected special arrangements

Transfer Admission

When receiving from another facility:

1. Set admitSource: "transfer"
2. Record origin facility
3. Review and apply transfer documentation
4. Continue or adjust dietary orders
5. Document handoff details

Bed Assignment

When assigning patient to bed:

1. Select appropriate department based on diagnosis
2. Check bed availability
3. Assign room and bed
4. Create initial EncounterLocation record
5. Update bed management system

Dietary Setup

When establishing meal service:

1. Review patient allergies from record
2. Apply condition-based diets
3. Note religious/cultural preferences
4. Set NPO if pre-surgical
5. Alert kitchen services

Related Entities

Calculated Fields

Enums

admitSource