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Based on interview, record review, and review of facility policies and procedures the hospital failed to confirm the receiving hospital had accepted a patient (Patient #1) for transfer for an inpatient admission.

Failure to confirm the receiving hospital has accepted a patient can cause a delay in patients being admitted for inpatient treatment.

Findings include:

1. Review of the facility policy titled "Transfer From Intake Department To Another Facility" effective May 2017; read in part "B. A Psychiatric/Medical Screening Exam, Medical Screening Exam Certification and Consent for Transfer shall accompany the patient being transferred".

"C. The transfer shall be completed with knowledge of and arrangements made for acceptance by the reciving facility/physician".

2. Review of Patient #1's medical record revealed the patient was did have an intake assessment at the Smokey Point Behavioral Hospital on 9/22/17. It was documented the patient was referred to the receiving hospital due to lack of beds available. The patient did not have a consent for transfer filled out to go with the patient to the receving hospital or a copy of psychiatric screening exam at the time the patient left the behavioral health hospital.

3. Review of Patient #1's medical record at the receving hospital Swedish Edmonds revealed the patient arrived to the emergency room expecting to be admitted for inpatient psychiatric services. The receiving hospital Behavioral Health Assessment Team (BHAT) had received the patient's assessment from Smokey Point Behavioral Health prior Patient #1 arriving at the emergency room. The receiving hospital had not accepted the patient for admission and no arrangements for transfer had been made. The patient arrived thinking that she would be directly admitted to the inpatient mental health treament unit.

The patient was evaluated again in the emergency room and was eventually admitted to the receiving hospital's inpatient psychiatric unit.

4. Staff A (Registered Nurse) was interviewed on 10/18/17 at 11:30 A.M.. The nurse stated the patient should not have been sent to the receiving hospital until it was confirmed the patient had been accepted as an inpatient. The patient and their parent shoud also have been given a copy of their assessment and the consent for transfer paperwork.

5. Patient #1 was interviewed by phone on 10/18/17 at 1:00 P.M. The patient stated they were evaluated for treatment by Smokey Point Behavioral Hospital but there were no inpatient beds available. The nurse called another hospital and was told the hospital may have inpatient treatment bed available. The nurse instructed the patient and their parent to proceed to the other hospital's emergency room for direct admission to the inpatient psychiatric unit. The patient explained there was some confusion when she arrived at the hopsital for admission but after being evaluated again in the emergency room she did get eventually admitted for inpatient treatment.

5. Staff B (Director of Assessment and Referral) was interviewed on 10/18/17 at 1:30 P.M. Staff B verified the above information.