Take a look at a policy in black and white

What we do on a daily basis’

At first glance, it might seem obvious, but then maybe not. What is the specific policy and procedure for how patients gain access to your facility? Hospital Access Management heard about the search for a hospital that had something down in black and white, and found an answer at Aurora HealthCare in Milwaukee.

Aurora’s policy, which became effective in December 1994 and is updated each year, "was started simply to designate how patients will receive access," says Rita Borowski, CHAM, metro region director of patient access services. "We put in writing what we do on a daily basis."

The policy "pulls it together that a patient’s ability to access service is everybody’s accountability within the facility," she adds. "Admitting handles their stuff, nursing handles theirs. It stipulates exactly what anybody should do."

The following paragraph introduces the policy: "Any patient, regardless of race, color, religion, national origin, handicap, HIV or related conditions, financial status, sex, or age, who presents with a valid physician order for inpatient or outpatient services will be provided services as prescribed."

Under the heading of "patient admission/registration," the policy specifies that elective cases may be delayed if there is a need to consult with social services, financial counseling, or behavioral health services staff or to arrange for a translator or TDD services, Borowski says.

A patient assessment will occur to make sure delays are not medically detrimental, she adds, and the following four guidelines will be followed:

1. Code four will be called for any patient who collapses or is otherwise in a medical crisis.

2. If a patient is in stress, but not crisis, the patient will be taken to the emergency department (ED) triage desk.

3. If a patient is urgent or emergent but not in evident distress, the patient will be assessed as needed by the ED triage nurse.

4. An admitting physician will be contacted if any service is being delayed to make sure patient care is not compromised.

In the second section, the policy addresses the steps that will be taken if a patient is seeking medical services but does not have a valid physician order, Borowski says.

The first three guidelines mentioned above will be followed in such cases, she notes. The fourth step, however, will be to contact other service areas in case an order has come to those departments rather than to the registration area, Borowski adds. "We also check area hospitals to see if the patient is supposed to be there. Maybe a person shows up saying, I’m supposed to have a stress test,’ but registration has no record of it, and the person has no paperwork. We make sure the patient is at the right location."

Subsequent sections cover patient class, whether emergent or elective, and how patients are transferred, if necessary, Borowski notes.

[Editor’s note: Rita Borowski can be reached at Aurora HealthCare, 2900 W. Oklahoma Ave., Milwaukee, WI 53215. Telephone: (414) 649-5518.]