Non-Scheduled Admissions

The HUC is integral to the clinical scheduling and registration hospital routines. Every patient encounter in the hospital requires a patient be registered in the hospital’s clinical software system. The type of registration questions, the  length of the registration procedure, and the resulting patient record varies greatly depending upon several factors including:

• whether the patient has already been “pre-registered” in the system,
• if they have been a previous patient in the facility, and
• type of service or treatment they are receiving.

The role of scheduling and registration in the hospital may be performed by many different categories of clerical staff depending upon the department, including HUCs, registration clerks, booking clerks, and ER clerks. You will note that all of these clerical roles are referred to in this section.

Although many admissions to hospital are pre-booked or pre-scheduled, there are some types which are not. In this section, we will discuss the registration processes for the following non-scheduled admissions: emergency admissions, direct admissions, and walk-in diagnostic testing patients.

Emergency Department Admissions

Admissions to the emergency room (ER) or emergency department (ED) are not pre-booked due to their emergent nature; therefore, the ED or ER registration clerk must complete a new registration for these patient visits/encounters when they present for treatment. Emergency admissions typically result from an acute illness, set of symptoms (i.e., chest pain), or accident (i.e., a fall). Less acute emergency patients may be assessed and treated fairly quickly in a sub-acute section of the ER department and discharged home from the ER within a few hours. More acute ER patients may require intensive testing, specialist consultation, operative measures, and/or admission to an inpatient unit.

Due to the acuity of some emergency patients, a full admission may not be completed upon their arrival. The ER registration clerk may complete a short registration for the patient to enter them into the system so that treatment may begin and update this information at a later period. ER registration clerks may also register patients under generic aliases when the patient has no identification and is unable to communicate or if an emergency crew calls in an urgent admission en route to the ER department.

If an emergency patient requires admission to an inpatient unit, their current ED registration must be changed to an inpatient registration and a bed assigned by the bed allocator.

Direct Admissions

Direct admissions are emergent admissions which occur directly from another health care facility or provider. The need for admission has already been ascertained by the MRP, so there is no reason for the patient to attend the emergency department for assessment. Some of the most common examples of direct admissions are transfers from other hospitals and repatriation of patients hospitalized out of province or country. Another less common example would be when a specialist assesses a patient in their office, ascertains they need acute hospitalization, and contacts the hospital to arrange admission directly to the patient care unit as their patient. In all these examples, the sending facility or physician must make arrangements with the bed allocator for admission.

Walk-In Diagnostic Testing Appointments

Some diagnostic departments within the hospital may accept patients for diagnostic tests without an appointment on a first-come-first-serve basis. Non-booked tests are typically simple tests which do not require patient preparation such as lab tests and simple X-rays. In these cases, the diagnostic imaging (DI) registration clerk must complete a new registration for the patient when they present for treatment.

References

Thompson, V. D. (2018). Administrative and clinical procedures for the Canadian health professional (4th ed.). Pearson Canada.

Attributions

“Emergency Signage” by Pixabay; used under the Pexels license.