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Admission and Discharge Criteria for IMC Status on F6/6 (2.1.15)

Admission and Discharge Criteria for IMC Status on F6/6 (2.1.15) - Policies, Clinical, UW Health Clinical, General Care and Procedures, Admission, Discharge, Transfer

2.1.15


UW HEALTH CLINICAL POLICY 1
Policy Title: Admission and Discharge Criteria for IMC Status on F6/6
Policy Number: 2.1.15
Category: UW Health
Type: Inpatient
Effective Date: December 18, 2015

I. PURPOSE

To ensure the use of a uniform policy w hen patients are admitted to and discharged from F66 Intermediate
Care (IMC) status.

II. POLICY ELEMENTS

Scope of Services: The IMC status has been designed to care for the adult plastic surgery patient w ho does
not meet criteria for admission to the ICU or to a general care f loor. These patients are hemodynamically
stable and often post operative, but require frequent monitoring to ensure optimum flap or replant functioning
or for early recognition and treatment of serious post operative complications. Admission of IMC status
patients to Surgical Specialties (F66) w ill only be inclusive of free f lap and replant plastic surgery patients. It
is the responsibility of the Plastic surgery physician, and/or designee to care for patients admitted to the unit
and assist w ith patient f low issues relating to admission or transfer of status criteria.

III. PROCEDURE

A. Admission Criteria-What follow s are examples of patient populations w ho are appropriate for IMC status
admission:
i. Plastic surgery
a. Any plastic surgery patient requiring monitoring of vital signs, urine output, respiratory
status, or other systems on a frequency of greater than every tw o hours. This could
include new postoperative patients, and/or decompensation of current general care
patients.
b. Continuous leech therapy
c. Flap monitoring every 30 minutes
B. Admission Process
i. Patients w ho meet admission criteria for IMC status w ill be admitted upon the request of the
attending physician or designee by contacting the Nursing Coordinator. Bed availability must be
determined prior to admission. In the event that the patient volume exceeds capacity, the Nursing
Coordinator w ill w ork w ith the Clinical Nurse Manager, or designee, and appropriate medical
service regarding w hich patient(s) w ill be admitted and discharged from IMC status on the Surgical
Specialty Unit. Nursing Coordinator and the Plastic Surgery Medical Director or designee to
evaluate appropriateness of admission and to resolve disputes.
C. Transfer Criteria to General Care Status
i. Resolution of issue requiring IMC status.
ii. Ability to safely monitor the patient under general care status.
D. Transfer Process
i. Patients w ill be review ed by case management, medical staff or their designee on a daily basis for
appropriateness for IMC level of care.
ii. A Health Link transfer order must be submitted to transfer the patient from IMC status indicating the
service, level of care and attending physician.
E. Discharge
i. Patients may be discharged to home or an appropriate care facility directly from the IMC. When
direct discharge from the IMC is appropriate, it w ill be completed according to UWHC policy #7.15-
Discharge Planning Process.
F. Conflict Resolution
i. Conflicts w hich arise regarding the admission and discharge of patients and priorities, w hich cannot
be adequately resolved by the parties involved, should be promptly referred to the Medical Director,
Transplant Service Line or Medical Director Surgical & Psychiatric Nursing for resolution.

IV. COORDINATION

Author: Clinical Nursing Director Surgical and Psychiatric Nursing;



UW HEALTH CLINICAL POLICY 2
Policy Title: Admission and Discharge Criteria for IMC Status on F6/6
Policy Number: 2.1.15

Senior Management Sponsor: SVP, Patient Care Services and CNO
Review ers: Outcomes Manager, Surgical Specialties; CNS, Surgical Specialty Unit; Clinical Nurse
Manager, Surgical Specialties; Chairman Plastic Surgery
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: November 16, 2015

UW Health is a cohesive, united and integrated academic medical enterprise comprised of several entities .
This policy applies to facilities and programs operated by the University of Wisconsin Hospitals and Clinics
and the University of Wisconsin Medical Foundation, Inc., and to clinical facilities and programs
administered by the University of Wisconsin School of Medicine and Public Health. Each entity is
responsible for enforcement of this policy in relation to the facilities and programs that it operates.

V. APPROVAL

Jeff Grossman, MD
UW Health CEO

J. Scott McMurray, MD
Chair, UW Health Clinical Policy Committee

VI. REFERENCES

McKesson Health Solutions, LLC. (2009). InterQual Level of Care Criteria. New ton, MA: McKesson
Corporation and/or one of its subsidiaries.
American College of Critical Care Medicine. Guidelines on Admission and Discharge for Adult Intermediate
Care Units (1998) Mar; 26(3): 607-610.
UWHC policy #7.15, Discharge Planning Process

VII. REVIEW DETAILS
Version: Revision
Next Revision Due: December 18, 2018
Formerly Know n as: Hospital Administrative Policy #7.09