Clinical Practice Guidelines

Admission criteria for general medicine SSU and IPU

  • There are always two General Medical teams on take: The Short Stay Unit Team and a General Medicine team (A to D, rotating daily). We rely on the emergency department to help decide which one is more appropriate for the child.

    Patients appropriate for the Short Stay Unit Team: (should fulfil ALL criteria)

    • Length of stay likely to be less than 48 hours
    • Clear diagnosis and management plan
    • Going to Dolphin ward
      • The SSU team only cares for patients in Dolphin and NOT on inpatient wards e.g. Sugar Glider, Cockatoo
      • Remember that even if the patient is going to Dolphin ward, they may not be appropriate for the SSU Team as per the above guidelines   

    Patients more appropriate for General Medicine A-D (as opposed to SSU) (ANY one of the below)

    •  Likely to stay > 48 hours
    • Complex
    • Requiring social support or more complex diagnostic evaluation
    • Patient groups that usually are more appropriate for the General Medical teams (rather than SSU) are:  
      • Feeding difficulties  
      • Failure to thrive  
      • Requiring allied health/Maternal child health nurse input

     If unsure whether SSU team versus Gen Med A-D is more appropriate, please discuss with the admitting registrar.     
     
    We realise that it is sometimes difficult to predict how long a patient will need to be in hospital e.g. children with asthma who have just completed burst therapy or bronchiolitis. We can only ask that you make your best assessment. If in doubt, talk to the admitting registrar. Sometimes a child is appropriate for Short Stay and is referred to the SSU Team but then deteriorates and requires a bed on the ward. If this is the case, please let the SSU registrar know and they will handover the patient to the appropriate Gen Med Registrar.  

    Neonates <28 days who require a General Medicine admission should be admitted under the Inpatient Unit bedcard (rather than the Short Stay bedcard). Where possible, admission should be to a bed on an inpatient (non-Dolphin) ward.  A neonate may only be admitted to Dolphin following a discussion between the Emergency Department consultant and the General Medicine consultant.  
     
    Note, this does not change the current practice that the neonatal consultant should be called for all neonates <7 days and for neonates 7-28 days with suspected meningitis


    Procedure for referring to the Short Stay Unit team and General Medicine teams A-D:

    General Medical patients in ED who are felt to be appropriate for the Short Stay Unit > Refer to the Short Stay Unit team Registrar and request a bed under SSU Team 

    General Medical patients who are felt to be complex or requiring a bed on the inpatient wards > Refer to the General Medical unit of the day (unless well known to a different Gen Med team in which case, refer to their usual home team)  

    Subspecialty team admissions in Dolphin:

    These children should be admitted under the specific subspecialty unit, and not SSU/Gen Med, if going to Dolphin ward.