Table 2

Guiding principles used in developing the rapid admission protocol

1. Patient hand-offs between evaluating service and admitting service must be clear and direct.
2. Responsibility and authority for the patient should be understood by all parties at any stage in the admission process.
3. Limit the number of steps in the protocol to the minimum necessary.
4. Interactions between the two departments must be marked by respect and professionalism.
5. Clinical disagreements must be escalated quickly through medical ranks of both departments.
6. Any staff member at any level must be able to alert leadership to problems; problems must be rapidly addressed.
7. Once begun, implementation of the new process must be total and complete.