By Tiffany Lai August 4, 2023
*Every hospital has different practices, so check in with your supervisors and coworkers on how your location triages.
There are some principles that generally apply across the board. The primary thought process is that you want to prioritize patients to make the hospital more efficient with discharges and admits.
The most important patient to visit first thing is the one that is ready to discharge but is just waiting for therapy to see them. This is because it is important for the hospital to clear rooms for new patients waiting to be admitted. Most of the time these are minor surgical patients or patients who have been in the hospital for awhile but are leaving that day.
The case manager or nurse might call you to ask you to prioritize this person. The white board in front of the nursing station might have an icon next to the patients name, indicating an imminent discharge. Case management notes might also mention a pending discharge. But the easiest way to know is to check in with the charge nurse at the start of your shift.
If your hospital is stroke certified with the joint commission, you need to see these patients at the frequency set by the initial evaluation or your department could get in trouble. These patients also have stricter time limits from admission to be evaluated, usually 24 hours. And for good reason! Time is of the essence with these patients and they have the potential to make swift progress with therapy.
These are patients who have undergone a procedure involving bones (hip and knee surgeries, fractures, spinal surgeries, etc). Early mobility is a really important factor towards healing and a quicker discharge from the hospital.
If a patient has been recommended to go to acute rehab upon evaluation, it is important to see these patients at the frequency set in the evaluation. This is because case managers are sending updated therapy notes to acute rehab sites (ARU) for them to decide whether or not to accept that patient. Your note can affect how quickly someone is discharged to ARU. Acute rehab wants to know that these patients can handle a rigorous therapy schedule, are progressing well, and are motivated to participate. It is important to reflect this in your documentation.
The rehab department of the hospital has a goal of seeing patients within a certain time frame, usually 48-72 hours after admission.
It can get pretty hectic out there! You might get calls from other healthcare professionals asking you to see their patient. Nursing might call you to ask when you’re getting someone up. Doctors might call saying a patient is wanting you to stop by. You have to be able to sift through the information and make the best judgment to help with the flow of patients in and out of the hospital.