Decisions relating to access and admission vary according to the services provided (acute or rehabilitation, medical, surgical and mental health), patient clinical requirements and the location of the facilities.
Before being admitted to Epworth, a patient's clinical needs are assessed and access may be subject to inclusion/exclusion criteria and to processes that assist in ensuring all patients receive appropriate care in the most appropriate setting.
Once the patient being admitted under your care has been identified, contact the appropriate bed coordinators to assist you with the admission of your patient at your site.
Following admission, multi-disciplinary systems will coordinate the ongoing care of the patient. Epworth employs formal booking systems or formal appointment systems depending on the services provided.
Paediatric services
Medical practitioners and surgeons undertaking paediatric surgery or interventional procedures must have an Epworth appointment with the relevant paediatric procedural scope of practice included. Epworth does not undertake any elective paediatric surgical procedure requiring care and invasive monitoring in an Intensive Care environment. All surgical paediatric bookings need to be approved by the Medical Director to ensure all risks are assessed to prevent the potential for adverse outcomes.
Anaesthetists undertaking paediatric anaesthesia must have an Epworth appointment with the scope of practice-paediatric anaesthesia included. The surgeon and the anaesthetist are required to be immediately available in person whilst the patient remains in recovery and always available by phone, for at least the duration of the inpatient stay (commencing from the time of transfer from recovery to the ward until time if discharge from the ward).
Please note, each division has its own specific admission criteria for paediatric patients. To access this information, please visit the Division Specific Paediatric Admission Criteria Appendix of our Admission Policy.
Please note that you will need to be logged into the staff intranet to access policies.
Resources for specialists and the clinical care of paediatric patients are available on the intranet, including medication resources, observation and life support guidelines.
Rehabilitation services
Patients can only be accepted for admission for rehabilitation following assessment by the Epworth Rehabilitation Assessment Service or through discussion with an accredited rehabilitation specialist.
Mental health services
The Epworth Clinic at Epworth Camberwell has a dedicated senior intake clinician who will assess and triage mental health referrals in accordance with the Mental Health Services Policy and Mental Health Services Admission Protocol. The on-duty intake clinician will determine access and appropriateness for admission to the service based on the service's ability to manage the patient in a private psychiatric setting. The intake clinical will also undertake a pre-admission assessment based on the referral and following inclusion criteria.
The patient has:
- a psychiatric condition that requires treatment
- agreed to not display behaviour which would impede their own and/or others recovery (antisocial and therapy interfering behaviours)
- been 'medically cleared' as appropriate to access the service
- capacity to consent to participate in treatment and provide informed decisions about the care and treatment they are about to receive
- expressed a willingness to engage in therapy programs and actively participate in their own treatment
See also:
Please note that you will need to be logged into the Staff Portal to access policies.
Discharge
Epworth's discharge processes are multidisciplinary, ensuring discharge plans are developed in partnership with health professionals, patients, families and carers.
Planning for discharge commences either at emergency admission, pre-admission or the admission stage and is ongoing throughout the continuum of care.
Patient discharge outcomes are assessed daily to ensure the following:
- discharge occurs within expected time frames
- the necessary mobility aids, home modifications and services are arranged prior to discharge and are in place
- the patient and carer have information relating to and are prepared for discharge
Effective discharge is achieved when:
- discharge summary has been completed for all patients ideally within 48 hours and a copy has been forwarded to each patients local general practitioner (GP)
- discharge time meets key performance indicator target of 10:00 hours
- length of stay is within expected time-frames
- the medical practitioner has deemed the patient clinically safe for discharge
- the patient/carer express satisfaction with the service, outcomes and ongoing care management
- there are no occurrences of clinical or process complications requiring re-admission
- there is timely, relevant and structured clinical handover that supports safe patient care
Financial exclusions and inclusions
Epworth reserves the right to deny admission to elective patients where the available evidence suggests costs of providing treatment may not be met. For patients who have a claim with an insurer, where the claim is accepted or not, Epworth may decline admission in the absence of written confirmation by the relevant insurer.
This may apply to overseas visitors with travel insurance or to patients with injuries subject to claims with Victorian WorkCover Authority, the Transport Accident Commission, or other similar insurers. If a patient is self-insured, they may elect to cancel or defer treatment based on the estimated cost of procedure. Epworth upholds the right to refer unmet debts to a debt collection agency or to the patient's appointed power of attorney (financial).
Further details are available in the Admissions Policy.
Please note that you will need to be logged into the Staff Portal to access policies.
Management of patients when you are unavailable
At Epworth, an inpatients must at all times be admitted under and attended to by an Epworth accredited medical specialist. At any point in time where the admitting specialist is unable to clinically care for or attend to the patient, they must identify another Epworth accredited specialist with the appropriate specialty qualification to take over the care of the patient.
Appointed specialists must provide informative and timely case notes and appropriate communication with patients and families, relevant nursing and healthcare staff, including those patients under shared bed cards. Once another appropriate Epworth accredited specialist is identified for taking over the patient's care, the original admitting Specialist is required to provide the details of:
- period of leave
- the name and contact details of the Specialist taking over the patient's care
The information must be conveyed by the transferring specialist:
1. Verbally
This information must be provided to:
- The patient
- The nurse unit manager/delegate of the ward
2. Written
An entry into the medical records of the patient being transferred must be made with contact details of:
- The Specialist taking over the patient's care
- Duration of patient being taken over (definite or with dates specified of the leave of the Specialist)
Phone messages should reflect details of arrangements and period of leave.