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STANDARDS UPON PATIENT’S ADMISSION
 This form to filled upon all patients course in the facility providing and maintaining the ACC chapter criteria to be all over the
 patients pathway in our facility

            STANDARD ACCORDING TO POLICY                            YES       NO       COMMENT AND SHORTAGE IF PRESENT
1. patients needs matching our facility mission
2. diagnostic tests available on OASIS
3. the patient needs holding for observation                                         If yes; why? ------------------------------------
4. Admission decision made after diagnostic test been
available
5. screening done at first contact point
6. Patient been admitted to best area in the facility
matching his/her needs.
7. is there any delay in delivering the service to the this                          If yes:
patient                                                                              Patient notified: √              ×
                                                                                     Delay form documented: √                  ×
                                                                                     Attached to the file: √          ×
                                                                                     Intervention: ------------------------------------
8. the patient and family received information about:                                Been emphasized in PTC format?
     • proposed care
     • expected outcome
     • expected outcome
9. is there any detected barrier to access and delivery of                           If yes;
service                                                                              Stated?
10. The records of patients documented for why being
transferred the other areas in hospital
11. There is clear plan of care in patients records
12. Individual responsible for the care plan of the
patient is identified and available.
13. Discharge planning wrote by qualified individual
14. Follow up instruction documented:
    • Understandable
    • Convenient
    • When to call urgent
    • Matching patients needs
    •
15. Do the family request for discharge summary?
16. Upon discharge, transportation assessment
documented in patients records

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Patient Admission Standards Form

  • 1. STANDARDS UPON PATIENT’S ADMISSION This form to filled upon all patients course in the facility providing and maintaining the ACC chapter criteria to be all over the patients pathway in our facility STANDARD ACCORDING TO POLICY YES NO COMMENT AND SHORTAGE IF PRESENT 1. patients needs matching our facility mission 2. diagnostic tests available on OASIS 3. the patient needs holding for observation If yes; why? ------------------------------------ 4. Admission decision made after diagnostic test been available 5. screening done at first contact point 6. Patient been admitted to best area in the facility matching his/her needs. 7. is there any delay in delivering the service to the this If yes: patient Patient notified: √ × Delay form documented: √ × Attached to the file: √ × Intervention: ------------------------------------ 8. the patient and family received information about: Been emphasized in PTC format? • proposed care • expected outcome • expected outcome 9. is there any detected barrier to access and delivery of If yes; service Stated? 10. The records of patients documented for why being transferred the other areas in hospital 11. There is clear plan of care in patients records 12. Individual responsible for the care plan of the patient is identified and available. 13. Discharge planning wrote by qualified individual 14. Follow up instruction documented: • Understandable • Convenient • When to call urgent • Matching patients needs • 15. Do the family request for discharge summary? 16. Upon discharge, transportation assessment documented in patients records