Inpatient Admission, Bed Management & Operating Theatres

This section describes the visual Bed Command Center, ward census tracking, bed state transitions, nurse staffing assignments, and surgical operating theatre scheduling.

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1. Admission Workflow & System Checks

1. Doctor Orders Admission: Attending physician documents the decision to admit from the Beds & Wards screen and selects the destination ward.
2. Automated Admission Validation Checks:
   • (a) Bed Availability Check: System verifies that the target bed is in Available status.
   • (b) Single Admission Check: System confirms the patient has no active admission at this facility. If either check fails, the admission is refused.
3. Admission Execution:
   • Source OPD or Emergency encounter is automatically closed.
   • Target bed status switches to Occupied.
   • A daily Ward Visit task is created for the attending doctor.
   • Inpatient nursing dashboard updates with the new patient and active orders.

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2. Interactive Bed Command Center & Status Lifecycle

The Bed Command Center provides real-time visual tracking of all inpatient units (Male Medical, Female Surgical, Pediatric, Maternity, ICU, Isolation).

stateDiagram-v2
    [*] --> Available: Bed Sanitized
    Available --> Reserved: Admission Requested
    Available --> Occupied: Patient Admitted
    Reserved --> Occupied: Patient Arrives in Ward
    Occupied --> PendingDischarge: Doctor Initiates Discharge
    PendingDischarge --> PatientDeparted: Patient Departs Ward
    PatientDeparted --> Cleaning: Housekeeping Initiated
    Cleaning --> Available: Clean Confirmed
    Available --> Maintenance: Maintenance Required
    Maintenance --> Available: Repair Complete

Bed Status	Visual Badge	System Meaning	Who Changes It	What Triggers It
Available	🟢 Green	Ready for next patient	System (after clean confirmation)	Bed cleaning confirmed after previous discharge
Occupied	🔴 Red	Active inpatient admitted	System (on admission)	Admission confirmed by doctor
Reserved	🔵 Blue	Held for specific incoming patient	Nurse / Administrator	Pre-admission or surgical planning
Maintenance	⚪ Gray	Bed or fixtures out of service	Nurse / Administrator	Equipment repair or biohazard maintenance
Cleaning	🟡 Yellow	Being sanitized after discharge	Nurse / Housekeeper	Patient departed; routine cleaning in progress
Pending Discharge	🟣 Purple	Clinical discharge in progress	System	Doctor initiates discharge summary
Patient Departed	🟠 Orange	Patient left; bed not yet cleaned	Nurse	Doctor/Nurse confirms physical departure

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IMPORTANT:

Infection-Control Terminal-Clean Gate A bed released from a patient flagged as infectious cannot return to Available status until an authorized clinical nurse or administrator explicitly confirms that a terminal clean was completed. This safety rule is enforced at the server level — it cannot be bypassed.

Visual Bed Command Center showing color-coded bed occupancy🔍 Click to enlarge

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3. Ward Transfers & Locking Protocol

1. Doctor or Nurse initiates a transfer request from the Beds & Wards screen.
2. Transfer Locking: The request enters Pending status. Both the patient's admission record and the target bed are locked during this process to prevent concurrent conflicts.
3. An authorized user (Admin or Charge Nurse) approves or rejects the transfer.
4. On Approval: The patient's ward location updates; the old bed releases to Cleaning status; the target bed status changes to Occupied.

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IMPORTANT:

Patient Safety Checkpoint: Concurrent Actions — Do Not Attempt Do not attempt to simultaneously approve a ward transfer and discharge the same patient. These two actions share a "release old bed" routine and concurrent execution is unsafe. Complete one action fully before initiating the other.

Ward-to-ward patient transfer dialog🔍 Click to enlarge

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4. Nurse Ward Staffing & Coverage

1. In Beds & Wards, open the Staffing & Coverage tab.
2. View active nurse-to-patient ratios across each ward.
3. Click Assign Nurse to Ward / Beds:
   • Select Shift (Morning 07:00-15:00, Evening 15:00-23:00, Night 23:00-07:00).
   • Designate assigned bed range (e.g., Beds 01 through 08).
4. Real-time patient clinical alerts and eMAR due doses for those beds route directly to that nurse's mobile and desktop dashboards.

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5. Operating Theatres (OT) Management

graph LR
    A[1. Scheduled Booking] --> B[2. Pre-Op & Anesthesia]
    B --> C[3. Surgery In Progress]
    C --> D[4. PACU Recovery]
    D --> E[5. Sanitization & Ready]

1. Theatre Status Board: Live view of all surgical rooms (e.g., Main Theatre 1, Emergency Theatre 2, Orthopedic Suite).
2. Schedule Surgical Booking:
   • Patient Name, Planned Procedure (e.g., Exploratory Laparotomy).
   • Lead Surgeon, Assistant Surgeon, Anesthetist, Scrub Nurse.
   • Planned Start/End Time and Blood Crossmatch Reservation Verification.
3. Theatre Utilization Analytics: Monitors room turnover intervals, surgical delays, and emergency case interruptions.