Mass General for Children direct admit policy, including same day or urgent admissions and elective or non-urgent admissions.
Medical Direct Admission Policies to Inpatient Pediatric General Care Units
Table of Contents:
I. Urgent Same Day Admissions
a. From outpatient office (PCP or subspecialty)
Admission to hospitalist service
Admission to subspecialty service*
b. From OSH (ER or floor)
Admission to hospitalist service
Admission to subspecialty service*
c. From Procedural Area within MGH
Admission to hospitalist service
Admission to subspecialty service
II. Elective / Nonurgent Admissions
Admission to hospitalist service
Admission to subspecialty service
*Subspecialists who may admit to their own service include: Cardiology, Endocrinology, Epilepsy, Gastroenterology, Hematology/Oncology, Nephrology, Pulmonology and Rheumatology.
I. Urgent Same Day Admissions
Patient Eligibility for same day/urgent Direct Admission from ambulatory settings or home:
- Patient meets age criteria as per MGfC policy and is less than 20 years old.
- Ideally, the patient has been seen by a Pediatrician/Pediatric Surgeon (MD) on the calendar day of admission.* On an individual patient basis, urgent direct admission from home can be considered without evaluation in ambulatory settings if an MD or NP/PA can see the patient within 30 minutes of arrival to the unit. If that is not possible, then the patient must present to the ambulatory setting or Emergency Department.
- Patient is clinically stable. This includes no urgent need of oxygen, intravenous fluids, antibiotics, or imaging. (If questions about clinical stability, please page hospitalist on call – 617-726-2000 Pager 21900.)
*Oncology patients with fever and neutropenia are the exception
a. From outpatient office (PCP or subspecialty)
Admission to Pediatric Hospitalist Service:
- Call the MGfC Pediatric Hospitalist on call at 617-726-2000 Pager 21900 to discuss the admission including patient demographics and pertinent clinical information. The hospitalist will arrange the admission and let the referring physician know about timing of bed availability and when to send the patient to the floor or admitting office.
Admission to Subspecialty Service:
- Call the Pediatric Resource RN (For Ellison 17: 617-724-5710; For Ellison 18: 617-724-5810) to obtain information about bed availability.
- Call the Pediatric Admitting Senior 617-726-2000 Pager 22522 (or Admitting Surgical Provider, if surgical patient) to discuss the patient and plan for admission. Information to include: brief patient history, weight, allergies, comprehensive medication list, any laboratory/diagnostic studies, and goals for admission.
- Call the MGH admitting office at 617-726-3393 (RSVP referral line) with pertinent patient demographic and clinical information (ie: name, DOB, diagnosis, and isolation need) and tell the admitting office which floor to pend the patient to.
b. From Outside Hospital (OSH) (ED or Floor Transfer)
The MGfC Inpatient units are available to outside hospital inpatient care units and Emergency rooms for direct admission if the patient is clinically stable. All patients will be screened by the pediatric hospitalist, pediatric surgeon, or subspecialist on call for eligibility. *If non-urgent transfer from outside inpatient floor – ensure insurance coverage.
Admission to Pediatric Hospitalist Service
- OSH clinician will call the Referral Access Line at 1-877-644-8988 and choose option 3 for general care admissions (MD Connect).
- MD connect will page the Pediatric Hospitalist to call the OSH clinician or conference the Hospitalist in to discuss patient history and goals of hospitalization.
- The Pediatric Hospitalist in conjunction with the floor resource nurses and resident admitting teams will determine disposition of the referred patient (direct admission versus to ED or another unit).
- MD Connect will provide referring physician with specific details of transfer, and provide information to facilitate RN to RN sign-out.
Admission to Subspecialty Service / Pediatric Surgery
- If an OSH wishes to arrange a direct admission to a subspecialty service or pediatric surgery, they will call 617-726-2000 to page the preferred Pediatric Subspecialty Service.
- The Pediatric Subspecialty service or Surgical Provider will call the Pediatric Resource RN (For Ellison 17: 617-724-5710; For Ellison 18: 617-724-5810) to obtain information about bed availability.
- The Pediatric Subspecialty Service will call the Pediatric Admitting Senior at 617-726-2000 Pager 22522 (or Surgical admitting provider if applicable) to discuss the patient and plan for admission. Information to include: brief patient history, weight, allergies, comprehensive medication list, any laboratory/diagnostic studies, and goals for admission.
- The Pediatric Subspecialty Service will call MD Connect 617-726-3384 with information about the referring facility (referring physician, phone #) as well as the patient (Name, MGH#, diagnosis, precautions) and book the bed on the appropriate floor.
- MD Connect will provide referring physician with specific details of transfer, and provide information to facilitate RN to RN sign-out.
c. From Procedural Area within MGH
Admission to Pediatric Hospitalist Service:
- Call the MGfC Pediatric Hospitalist on call at 617-726-2000 Pager 21900 to discuss the admission including patient demographics and pertinent clinical information. The Pediatric Hospitalist will arrange for the bed through the admitting office and coordinate timing of transfer.
Admission to Pediatric Subspecialty Service:
- Call the MGfC Operator at 617-726-2000 to page the preferred Pediatric Subspecialty Service to accept patient (call back time: approximately 30 minutes) and discuss patient history and goals of hospitalization.
- Accepting Pediatric Subspecialty will call the Pediatric Resource RN (For Ellison 17: 617-724-5710; For Ellison 18: 617-724-5810) to obtain information about bed availability
- Call the MGH admitting office at 617-726-3393 (RSVP referral line) with pertinent patient demographic and clinical information (ie: name, DOB, diagnosis, and isolation need) and tell the admitting office which floor to pend the patient to.
- Subspecialty service will coordinate timing of transfer with nursing.
- Accepting Pediatric Subspecialty Service will call MGfC Pediatric Admitting Senior at 617-726-2000 Pager 22522 to discuss the patient and plan for admission.
II. Elective or Non-urgent Admissions
As a general rule, planned direct admits should have been seen by the referral in the office within the previous 30 days.
- On the morning of admission, the family can call Ellison 17 (617-724-5710) or Ellison 18 (617-724-5810) to determine the timing of their arrival.
- In the event that there is no bed availability, the Pediatric floor nursing will contact the Admitting Subspecialty Service to inform them and the Subspecialty Service will contact the family to make appropriate arrangements.
Admission to Pediatric Hospitalist Service
- Email or page the MGfC Pediatric Hospitalist on call at 617-726-2000 Pager 21900. Include Name, MRN, diagnosis, date of admission request.
- An Intake form will be provided to the requesting MD to include additional required information to plan the admission.
- The Pediatric Hospitalist team will book the planned admission through the admitting office for the requested date and referring physician will be notified to communicate details with the family.
Admission to Subspecialty Service
- Call the MGH admitting office at 617-726-3393 to provide pertinent patient demographic and clinical information (ie: name, DOB, diagnosis, and isolation need).
- A clinic or preadmission note in EPIC is required the day of admission prior to patient’s arrival to the floor.
- On the day of admission, Accepting Pediatric Subspecialty Service will call MGfC Pediatric Admitting Senior at 617-726-2000 Pager 22522 to discuss the patient and plan for admission. Information to include: brief patient history, weight, allergies, comprehensive medication list, any laboratory/diagnostic studies, and goals for admission.