1. Patient Flow in a Hospital
Departments involved and interface activity

2. 911: The Bronx, Saint Barnabus Hospital
• https://youtu.be/AfKuwOynVCU?t=864

3. Registration
Medical Nursing Station
Intensive Care Unit
Surg Nursing Station
Emergency Department
Recovery Unit
Business Office
Hospital Administration
Laboratory Department
Pharmacy Department
Radiology Department
Surgery Department
Physical Therapy
Dietary Department
Coders
ExternalTranscriptionService
Pyxis
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Major Departments in CHS Hospitals

4. Normal Inpatient flow in CHS Hospital
Registration
Nursing Unit
Surgery
Recovery
Nursing Unit
Ancillary Depts.
Business office

5. OB Registration
• https://youtu.be/dYrCmI9Dsdw?t=2

6. OR PEDS Registration
• https://youtu.be/7fXzsKqtqbw?t=14

7. Inpatient Flow for Hospital Stay
Registration
Patient goes to
Registration
Registration Functions are:
• Schedules Patients for arrival at hospital facility
• Collection of Demographic Information
• Collection of Financial information for billing
• Prints Face sheet to the patient chart
• Prints and attaches arm band to patient
• Assigns patient room and bed they are to occupy
• Sends patient off to nursing station
Ancillary Departments
Pharmacy
Lab
Radiology
Registration
Software utilized:
• Medhost Patient
Accounting
• Cerner FirstNet
MModal
HL7Interface

8. Inpatient Flow for Hospital Stay
Nursing Station
Patient arrives at
nursing station
Placed in a Bed
Nursing Station Functions are:
• Doctor makes rounds and provides
orders to be filled.
• Create orders
• Receive Results
• Schedule Surgery, Tests to be performed
• Carry out procedures given by Doctor
• All activity is documented in our system
Ancillary Departments
Pharmacy
Lab
Radiology
Software utilized:
• Medhost
• Patient Care
• Clinview (clindoc)
• MModal
• Green Screen
• Pyxis
• Cerner
• Pharmnet
• Pathnet
• Radnet
MModal
HL7Interface

9. Patient vital signs are collected
• Vital sign monitors are placed on the patient selected
data is entered into the patient chart and may also
set off alarms to call staff to the patient bedside.
Monitors
and
network

10. Patient care and documentation starts
• The nurses evaluate each patient and
documents in the patient record.
Cerner
Patient
Care

11. Computerized Provider Order Entry
links to every department
• Orders are transmitted to appropriate departments
which send staff to perform procedures and nurses
to evaluate, administer care, medications and notify
the physician.
Order
sets

12. Pharmacy and nurses collaborate to
medicate patients with precision.
• Barcodes from the beginning to end of the process
are a mandated safety requirement.
Barcoded wrist band
patient identification Bedside medication identification
All medications barcoded by manufacturer or pharmacy

13. Lab collects, analyzes and reports
• Data is placed into the patient chart and is reported
to state and federal health departments
Barcode label on each tube Analyzer data output to records

14. Medical Imaging
• The patient is transported to imaging, images are
collected and posted to the patient chart to be
reviewed by physicians.
Image generation Image viewing

15. OB Registration
• https://youtu.be/7fXzsKqtqbw?t=14

16. Inpatient Flow for Hospital Stay
Surgery
Patient arrives
at Surgery
Surgery Functions are:
• Scheduling Patient and Surgeon for
Procedure to be performed
• Create Pre-Operative orders
• Create Post-Operative orders
• Assure all supplies are obtained from
Material Management
• Perform procedure
• Send patient to recovery unit
• Patient is returned to nursing station
Ancillary Departments
Pharmacy
Lab
Radiology
Software utilized:
• Medhost
• PIMS
• Mckesson PHS/HMS
• Cerner
• SurgiNet
• HSM/PHS Horizon
Surgery Manager
(McKesson)
Materials
Management
HL7Interface

17. Physicians have no extra time in
emergencies to waste
• Pre-surgical evaluations by OR staff and physicians
get documented and dictated.
Dictation softwarePhysician documentation software

18. Critical patient data is collected and
documented almost continuously
• Patient into recovery room. Post op orders entered
by physicians.
Image systemClinical documentation Monitor system

19. Inpatient Flow for Hospital Stay
Patient Returns to Nursing Station
Patient returns to
Nursing Station
Nursing Station completes doctor
orders, procedures and results until
patient is ready to be discharged.
Ancillary Departments
Lab
Radiology
Software utilized:
• Medhost
• Patient Care
• Clinview (clindoc)
• MModal
• Green Screen
• Pyxis
• Cerner
• Pharmnet
• Pathnet
• Radnet
Pharmacy
Physical TherapyHL7Interface

20. Nurses and all services document in
the patient record
• Patient moved to room on nursing unit.
• Vital signs monitored and documented.
• Medications administered and documented.
Clinical software & networkMonitor & network

21. All services provide care for the
patient and document in the record
• Ancillary departments (RT, PT, OT, ST, Dietary)
evaluate and perform treatments as ordered.
softwareDietician consult &menus

22. Inpatient Flow for Hospital Stay
Business Office
Business Office Functions are:
• Discuss with patient how bill is to be
paid prior to being discharged.
• Coders code bills for reimbursement
from Insurance companies
• Shared Services personnel follow up
with insurance companies and patients
to bring bills to zero balance.
Business Office
Software utilized:
• Medhost Patient
Accounting
• HIM 360 3M
• Cerner FirstNet
External from Facilities
Coders assign ICD-10
Codes to patient account
for reimbursement
purposes

23. Inpatient Flow for Hospital Stay
Patient leaves Facility

24. Emergency Room Patient flow in CHS Hospital
ER Registration
ER Unit
Nursing Unit
Ancillary Depts.
Business office

25. 911: The Bronx, Saint Barnabus Hospital
• https://youtu.be/KZQ0HUpb9zs?t=1412

26. New York Med
• https://youtu.be/mn_AT2IOkNo?t=307

27. Patient is treated by EMS staff prior to
arrival at the Emergency Department
• Ambulance has onboard computer for prehospital
patient record. This record will be uploaded to the
patient record at the hospital.
Document
upload to
patient record

28. Patient arrives at hospital and enters
the Emergency Department
• Patient registration occurs.
• Eligibility verified.
Patient Registration
software

29. Patient care and documentation starts
• The nurses evaluate each patient and
documents in the patient record.
Patient
tracking

30. Emergency Room Patient flow in CHS Hospital
ER Unit Stay
Patient arrives at
ER Unit
Emergency Room Function:
• Provide patient care and
get patient off to Nursing
Unit.
• Provide patient care and
send Patient Home.
Ancillary Departments
Lab
Radiology
Software utilized:
• Medhost
• EDIS
• HMS
• Cerner
• First Net
• Powerchart
Pharmacy
HL7Interface

31. Patient Billing Process – Shared Services
Shared Services
Software utilized:
• Medhost Patient Accounting
• HIM 360 3M
• Cerner FirstNet
• PASI
Patient
Demographic
s Entry
Insurance
Eligibility
Charge Posting most
posting are bi-
products from orders
and results
ICD-10, CPT
Coding
Claims Submission
Electronic Bill &
Paper Billing
Claims
Payment
Posting
A/R Follow up
Denial
Management &
Appeals
Patient
Statement
Reporting
Bad Debt
Process
Payment posting.
Brings Account to
zero balance
Remote Coder
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32. Questions