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Medical2-Midnight Rule
By btbates
Category: Medical. Viewed 1202 times. Created November 2013.     Disclaimer.   
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Decision to Admit Patient
YES
Will treatment exceed >2 midnights? Also consider clinical presentation: Patient History; Comorbidities; the Severity of Signs and Symptoms; Current Medical Needs; Risk of an Adverse Event
NO
Order "Admit to" Observation Services
Utilization Management Review (within 24 hours) Is Observation status appropriate?
YES
Discharge Patient or UM reassessment next day



YES




NO


 
1) Enter "Admit to Inpatient" Order in IMPACT Residents/Fellows; CRNPs/PAs; and RNs* * - RNs per verbal order from attending physician 2) Attending Physician add "Inpatient Admission Auto-Text" to admission H&P. Fill in required fields with pertinent clinical information. 3) Signature of Attending Physician authenticates Inpatient Order and Certification.
 
UM will send for level of care determination
 









 
YES
Utilization Management Review (per protocol) Is Inpatient status still appropriate?
 
Is Inpatient Admission appropriate?
NO
 



NO






 
UM will send for level of care determination
UM contacts physician for change in status correction.