G. Policy

1. The patients would be admitted only for services, which are available with our hospital. All patients who are to be admitted should complete necessary registration process.
2. If the services are not available within the hospital, the emergency care must be provided to all the patients coming in critical condition (emergency). Only after being stabilized, the patient will be transferred to any other medical facility.
3. The patient would be admitted only under the doctor who has the privileges of admitting the patient at hospital. Also the privileges are decided for doctors only by Head Operations and Medical Services.
4. Patient is admitted based on their choice and availability of type of room categories. The patient would be admitted as per level of care required. (ICU, ward).
5. In case of unidentified patient, he/she shall be registered and admitted as Medico legal case and Medico-legal case procedure shall be followed.
6. The patients who are required to be admitted for less than 6-8 hours will be considered as day care procedures, and will be admitted as Day Care Patients.
7. Access to the healthcare services in the organization is prioritized according to the clinical needs of the patient.
8. Bed management would be done to manage elective and emergency admissions effectively and efficiently in the hospital. This includes the procedure to manage in case of non-availability of beds.

H. Procedure

There can be two sources for admission of patient in the hospital:

H.1 Sources of Admission

1.1 Hospital Direct

Patients directly coming into the hospital, either for emergency care or elective care through emergency department, Out-patient department, day care or direct walk-ins.

1.2 Referred

1. Referred through the family physician/attending doctor of the patient.
2. Referred or transferred through another hospital or nursing home.
3. Referred through a third party payer (e.g. any corporate company)

H.2 Criteria for Admission

1. Any patient that needs to be kept under observation of the medical staff
2. Any patient who needs to be given medication under medical supervision
3. Any patient that needs to undergo any procedure / Surgery related to specific symptoms.

H.3 Selection of Consultant

1. The patient has right to select the consultant under the care of whom he/she wants to get admitted.
2. If a patient is hospital direct, the selection of attending consultant should be based on the personal preference of the patient/relative, if there is any. Or he/she should be admitted as per the emergency on call schedule of the consultants.
3. If a patient comes with the admission note of any consultant who has clinical privilege of admitting the patient in SMVS Swaminarayan Hospital, the patient will be admitted under his care, entering the name of the consultant as the attending consultant in hospital records.
4. If a patient comes with the admission note of a consultant, who does not have the privilege of admitting patient at the hospital, the patient should not be admitted under his care. The patient/relative should be explained regarding the same.
5. The customer care officer or clinical staff at Emergency department will communicate it to the consultant and if he recommends any other consultant (who has the SMVS Swaminarayan Hospitals privilege to admit the patient), the patient will be admitted under his care.
6. If there is no recommendation by the consultant (who does not have the privileges), and the patient/relative has any personal preference for the selection of consultant, the patient will be admitted under care of that consultant.
7. If the patient/relative does not come with an admission note but he/she is referred by a doctor, the admission officer will contact the referring doctor and enquire about the details of admitting and attending consultant.

H.4 Admission Procedure

1. Patient is received at admission department with OPD or emergency assessment notes as per Consultant’s advice on admission process.
2. Staff checks patient is registered previously in hospital or not. If he is registered, he has given been UHID No. which contains all detail of patient.
3. IP number generated in reference of UHID number
4. If the patient has come to the hospital for the first time he/she gets registered with the hospital as per the registration policy.
5. The information in the Admission form has to be filled with complete patient’s personal & reference details.
6. Customer care Officers will ask for the ID Proof of patient or patient’s relative for the office use and for proper documentation.
7. Customer Care officers ask the patient to fill the admission form. The form has to be filled by the patient or his/her relatives in his/her own handwriting. In case, minor and physically/mentally ill patient, legal guardian has to fill the form.
8. In case the Admission form is filled by any distant relative of the patient, it is the responsibility of the CCO staff to follow up with close relative (Like Mother/Father/Sibling/Spouse) regarding the patient’s details.
9. The complete patient details have to be entered in the system with cross check while saving the details.
10. UHID number will be generated. After generation of UHID no. through HIMS, patient would then only be allowed to get admitted. The UHID No. of the patient would always remain same for using any hospital services in future. E.g. Readmission or out-patient consultation etc.
11. On entering UHID No. in HIMS, IP No. will be generated automatically. IP no. would be different for all the admissions of the same patient. All the admission related details like admitting and attending doctor should be entered into the HIMS.
12. Patient would be explained about the types of classes/room category from the Hospital Tariff Cards i.e. as follows:
    1. Standard
    2. Semi Special- Triple sharing
    3. Semi Special- Twin Sharing
    4. Special
    5. Deluxe
    6. Suite
    7. Chemotherapy Unit
    8. ICU
    9. ICU- Isolation
    10. NICU
    11. Day Care Unit
13. If selected category room is not available, then the patient shall be temporarily admitted in the class available and will be shifted to the selected category of room as soon as it gets vacant. During that period, the room charges shall be based on the room which patient has currently occupied while the other charges shall be based on the category selected by the patient.
14. In case of Standard room selection, male patient will be assigned to male ward in priority, if available, and female patient will be assigned female ward in priority, if available. In case of high occupancy or non availability of beds, male or female patient can be given alternative available beds as per the policy.
15. Patient is provided with approximate estimate by billing department and accordingly deposit will be paid by patient.
16. Once the admission procedure is completed, the CCO staff informs about the room no. /bed no. to respective floor’s Nursing In-Charge and IP Coordinators. Also makes sure that the room/bed is ready before the patient reaches their unit.
17. CCO staff prepares the patient’s file, which includes the Admission Form, General Consent Form, Estimate Form and Attendant pass will be given to patient/ Patient’s relative. The patient is educated regarding rules and regulations about the hospital. They are being told about the patient rights and responsibilities during their stay in the hospital.
18. The Emergency staff escorts the patient/relative to the room with proper guidance, only after the completion of admission process by CCO staff.
19. If the patient is unable to walk, the attendant would arrange wheelchair/stretcher for him.

H.5 Admission procedure for Unidentified Patients

1. Patient coming or brought to emergency without any identification details (name, address etc.) shall be registered as MLC cases with registration details clearly mentioning unidentified status of the patient. The identification details shall be updated as soon as identification is confirmed.
2. Patient is received at emergency with assessment notes as per Consultant’s advice on admission process.
3. Patient is registered with UHID number “Unidentified 1,2.”Etc
4. IP number generated in reference of UHID number.
5. Admission desk staff shall fill the admission form manually.
6. The complete patient details once received should be entered in the system with cross check while saving the details.
7. The admission process would remain same.

H.6 Admission procedure for Corporate Patients

1. If patient is corporate patient all the basic procedure will be same
2. The CCO staff shall collect the Reference Letter / Employee Identity Card of respective organization and a doctor note from the patient.
3. The CCO staff will coordinate with Assistant Manager Marketing and Communications for the approval and will facilitate the process accordingly.
4. The class for admission is allotted according to the employee / beneficiary’s entitled grade assigned from the company.
5. In case if patient is admitted in Emergency, the relevant documents shall be collected latest on the same day or on the next day of admission.

H.7 Admission procedure for TPA Patients

1. In case of Planned Admission: The Authorization letter shall be handed over to CCO desk staff prior to admission of the patient along with the room category.
2. Advance amount (as per hospital policy) of the total estimate to be collected from the patient at the time of admission.
3. In case of Unplanned Admission: The information of the patient shall be given to the TPA Desk and the relevant documents shall be collected latest on the same day or on the next day by the TPA Help Desk Department.
4. The patient shall be explained that the admission is irrelevant to the approval and in case of denial; the patient shall be responsible to make the whole payment.
5. The patient shall be explained that in case he/she has to undergo a surgery before approval from the TPA Company or services given extra or not included in the approval, then the patient has to deposit the total amount before the service is availed.

H.8 Guidelines for Issue of Passes to the Relatives

Visiting Hours: With Attendant & relative pass as per the guidelines
Other visitors: During visiting hours only (i.e. 4:00PM to 6:00PM) Entry of children is restricted.

H.9 Management of beds during high occupancy or during non availability of beds.

Beds are assigned according to the following guidelines:

1. When beds are available these are routinely allocated on first cum first serve basis, keeping the patient request as well as medical condition in view.
2. In case of high volume of patient, floor bed are provided according to the medical condition of the patient and availability of room category required.
3. Category wise beds are allotted. If desirable category is not available, then higher category is allotted till the required category is available and vice versa and charges till that bed available will be applicable according to the room category allotted to the patient.
4. Priority for bed allocation when there is shortage of beds. Critical patients will be given first priority in allocation of beds (as per triage).
5. If no bed available, then patient can be referred to the other units.
6. For patients being transferred from another hospital, the external facility may be asked to hold the transfer until the room is available.
7. In case no bed is available in hospitals, then refer the patient after confirming the bed availability in hospitals.

H.10 Day Care Department

1. Patients admitted in the hospital for procedures not requiring overnight stay in the hospital and staying for maximum 6-8 hours for any medical or surgical conditions would be considered as daycare patients.
2. Day care admission timings are from 9:00 AM to 6:00PM
3. All day care patients to be discharged before 6:00PM
4. Day care billing to be completed within defined timeframe.
5. Patient to be registered if not registered earlier with the hospital
6. General consent for treatment to be taken after explaining all the details
7. Services provided are:
   1. Medical and Nursing Services
   2. Regular housekeeping and attendant services
   3. Cafeteria Services
8. Any daycare patient’s stay exceeding 6 hours would be converted to in-patient, and then IP admission would be done as per the protocol, room charges would be charged as per admission charges criteria. Estimate form will be given and signed get signed by the relatives and Admission Department will issue the passes to the relatives as that patient is counted as a Inpatient.