SHM Converge Scientific Abstract ePoster Gallery-Admission Status Accuracy: Ed Physicians Versus Admitting Services

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The document describes a study at UC San Diego Health comparing the accuracy of hospital admission status orders written by emergency department (ED) physicians versus admitting-service physicians. Admission status must be designated as inpatient, outpatient, or observation, and errors can be measured using Medicare claim indicators such as Condition Code 44 (CC44) and W2.<br /><br />The hospital changed its workflow in November 2022: instead of ED physicians entering the admission status after discussion with the admitting team, admitting physicians entered it directly. This change was evaluated using interrupted time series analysis.<br /><br />Results showed no statistically significant difference in admission status accuracy between the two workflows. The average error rate was 5.7% in the pre-implementation period when ED physicians entered orders, 5.1% during the period when admitting services entered orders, and 6.7% after the workflow reverted back to ED physicians entering orders in May 2023. Statistical testing found no meaningful level or slope change associated with the intervention.<br /><br />The main conclusion is that, at this institution, there was no significant difference in accuracy between ED physicians and admitting-service physicians when placing admission status orders. The authors note that provider familiarity and workflow processes may vary by institution, and recommend collaboration between hospitalists and utilization review teams to improve admission status accuracy.

Asset Subtitle

Diana Childers

Meta Tag

Author List Brian Clay, Bryan Huang, Diana Childers, Donna Beifus, Jarrod McDonald, Maryann T. Ally, Vaishal Tolia

Category Innovations

Concept Admission Status

Concept Hospital Admission

Concept Outpatient Admission

Concept Observation Status

Concept Admission Status Order

Distinguished Non-Finalist

Presenter Organization UCSD Health

Presenting Author Diana Childers

Track Other

Keywords

admission status orders

emergency department physicians

admitting-service physicians

UC San Diego Health

hospital admission accuracy

Condition Code 44

W2 indicator

interrupted time series analysis

workflow change

utilization review

Admission Status

Hospital Admission

Outpatient Admission

Observation Status

Admission Status Order