Record a Safe Admission Case

Record a Safe Admission case

One entry per patient. Use the MRN only — no name or national ID. Saved cases go straight to the medical director.

MRN *

Date of decision *

ER physician who ordered Safe Admission *

Primary specialty requested *

MRP contacted? *

MRP contact date / time

Specialty decision *

Final admitting specialty

Patient actually admitted?

Escalated? *

Rejection / delay reason

Required when the decision is Rejected or Pending.

Diagnosis and notes in brief