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Admission and Discharge Criteria for IMC Status at The American Center (2.1.7)

Admission and Discharge Criteria for IMC Status at The American Center (2.1.7) - Policies, Clinical, UW Health Clinical, General Care and Procedures, Admission, Discharge, Transfer

2.1.7


UW HEALTH CLINICAL POLICY 1
Policy Title: Admission and Discharge Criteria for IMC Status at The American Center
Policy Number: 2.1.7
Category: UW Health
Type: Inpatient
Effective Date: September 17, 2015

I. PURPOSE

To ensure the appropriate use of the Intermediate Care (IMC) beds located at The American Center, and to
outline guidelines for the admission and discharge from Intermediate Care beds.

II. POLICY ELEMENTS

IMC status at The American Center is designed to care for the adult patient w ho fails to meet acuity criteria
for admission to the General Care f loor. These patients are hemodynamically stable, but require frequent
monitoring for early recognition, and treatment of potentially life threatening events.

III. PROCEDURE

A. Admission Criteria
i. Invasive monitoring to include arterial lines for blood pressure management and monitoring and
central lines.
ii. Stable dysrhythmias requiring continuous monitoring of ECG and/or continuous antiarrhythmic drug
infusions. Administration of intravenous medications should occur according to UWHC Policy 8.31
Guidelines for Hospital Location Specif ic Administration of IV Medications and the UW Health
Clinical Practice Guideline – Intravenous Administration of Formulary Medications – Adult –
Inpatient/Ambulatory
iii. Decompensation of a general care patient’s condition requiring cardiac monitoring of vital signs,
cardiac status, urine output, respiratory status, or other systems on a frequency of greater than
every four hours. This could include new postoperative patients and/or decompensation of current
general care patients.
iv. Respiratory needs of the patient including: continuous CPAP, continuous BiPAP and/or High Flow
Nasal Cannula.
v. Blood product requirements including up to four units of packed red blood cells in a 24 hour period.
vi. Select Intermediate Care level drains including abdominal vacs.
B. Admissions Process
i. Patients meeting criteria for IMC status w ill be admitted upon request of the attending physician,
Anesthesiologist or Hospitalist by contacting the Care Team Leader of Overnight Care. Bed
availability must be determined prior to admission. In the event that patient volume exceeds
capacity, the Care Team Leader w ill w ork w ith the Nurse Manager and physician to triage the
patient to the appropriate level of care.
ii. Patients being admitted for IMC status must be seen w ithin 2 hours by the Hospitalist.
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. Discharge
i. Once appropriate transfer criteria from Intermediate Care has been met, a physician order w ill be
entered into the electronic medical record to indicate the appropriate level care.
ii. When discharge from Intermediate Care status is appropriate, it w ill be completed according to
current UWHC policy #7.15 Discharge Planning Process.
iii. If patient requires an increased level of care that is not able to be provided at The American Center,
patient transfer w ill occur according to UW Health Clinical Policy Transfer of the Decompensating
Patient from The American Center.

IV. CONFLICT RESOLUTION

Conflicts w hich arise regarding the admission, transfer and/or discharge of patients and placement priorities
that cannot be adequately resolved by the parties involved should be promptly referred to the Nurse
Manager for resolution.





UW HEALTH CLINICAL POLICY 2
Policy Title: Admission and Discharge Criteria for IMC Status on the Heart and Vascular Progressive Care Unit
Policy Number: 2.1.7

V. COORDINATION

Author(s): Nurse Manager, Overnight Care at The American Center Unit; Director, Overnight Care at The
American Center
Senior Management Sponsor: VP, Clinical and Interventional Services, and Chief Nursing Officer
Approval committees: UW Health Clinical Policy Committee
UW Health Clinical Policy Committee Approval: April 20, 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.

VI. APPROVAL

Jeff Grossman, MD
UW Health CEO

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

VII. REFERENCES

UWHC Policy #7.15: Discharge Planning Process

VIII. REVIEW DETAILS
Version: Original
Next Revision Due: September 17, 2018