Delay from inpatient admission to evaluation

[xavier2000]

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My understanding from a CMS point a view is that a new psych admission needs to be evaluated within 60 hours.

CMS437

While acknowledging that jurisdictions may require more restrictive guidelines, in general what what would the collective think is standard of care and appropriate.

I say 24 hours. I think accepting an admission at say 3pm, placing admission orders, and seeing the patient the following morning is fine and common. I think going beyond 24 hours we are providing less than good care.

Discussion please.

 

[nexus73]

I think by somewhere between 18-24 hours depending on staffing and institutional needs.

 

[dl2dp2]

Depending on the hospital. For one thing, I think admission (transfer) into a state hospital doesn't need to be within the first 24 hours, and I think that was the original intent of the CMS advisory being somewhat longer than what you'd expect. A lot of state hospitals don't have staff to do admissions on weekends.

 

[michaelrack]

The 60 hour rule is often used by senior care units.... usually a medical doctor (fp or IM) will do a medical h and p within 24hours and a psychiatrist will do the psych evaluation within 60hours

 

[Mass Effect]

The 60 hour rule is often used by senior care units.... usually a medical doctor (fp or IM) will do a medical h and p within 24hours and a psychiatrist will do the psych evaluation within 60hours

This. In my experience, the admission is done by someone; just may not be done by psychiatrist for 24 hours (I've never heard 60 hours).

 

[Sushirolls]

I've worked at 2 places that had 24 hours from setting foot on the unit, the clock started, and at minimum a Psychiatrist or Internist in 24 hours was sufficient to stop the clock. I have seen patients get on the unit 11AM one day, but not seen until 2PM the next day kind of thing, so 28 hours is a bit more real world encapsulating.

 

[AnnoyedByFreud]

where I work we have 24 hours to have the eval done once the patient hits the floor.