Bed Assignments

We use a house officer for the whole house and a charge nurse is on each floor. We also use pagers and a computerized charting system that has throughput on it.

The house officer gets the admit and assigns it to the most appropriate floor and then the resource of that floor gets a page and assigns the patient to the most appropriate nurse.

House supervisor gets notified there is an admission, chooses the appropriate unit to place the admission & contacts the charge on that unit for the bed placement. At that time, charge can bring up any concerns for receiving the new admit (short staff or drowning under unusually high acuity pts) which might result in the pt going to a different unit. The supervisor keeps tabs on the census & staffing for each unit, so that's usually not an issue. Charge chooses the room & which nurse will take the new admit.

House supervisor gets notified there is an admission, chooses the appropriate unit to place the admission & contacts the charge on that unit for the bed placement. At that time, charge can bring up any concerns for receiving the new admit (short staff or drowning under unusually high acuity pts) which might result in the pt going to a different unit. The supervisor keeps tabs on the census & staffing for each unit, so that's usually not an issue. Charge chooses the room & which nurse will take the new admit.

This is pretty much how our facility does it as well.

And it seems to work unless someone writes down the wrong room or the transportation tech can't read and the patient goes to the wrong room (only happened once that I'm aware of).

Where did all my faces go? I want the eye roll face?

I'm guessing you don't use a computer system for documentation?

Often, we get called - but we usually know before we get called if we're paying attention to the computer. The unit manager in Epic shows all pending transfers. Before a bed is assigned, we can see that someone is pending in to the unit, but doesn't have a room number. There is a conversation between bed control and the unit team leader, who has been in contact with the different sections' charge nurses, to see what room it makes the most sense for the patient to go into. Bed control then assigns the room in the computer. The receiving nurse, or whoever is helping with the admission/transfer, drags the patient into the room in the unit manager and that completes the transfer once the patient arrives.

It's not terribly uncommon for me to have thoroughly reviewed my chart, to the point that I tell the nurse who calls me report that I'm good and don't need any more info, I'll just see her when she gets there, before whoever's doing team gets around to telling me I have a patient coming.

I can't imagine anyone as high up as an ADON being involved in bed assignments. We have 70+ RNs on my unit alone; I imagine we have at least a couple thousand working for the hospital. How could the ADON possibly assign beds appropriately to the appropriate staff, and know exactly what other patients are in that particular nurse's assignment? That just sounds nuts. No wonder you're having problems.