Hospitalization Information

The Hospitalization Information screen allows users to enter detailed information about the hospitalization of an individual. This screen appears for incidents with the primary categories of: Hospitalization, Psychiatric Hospitalization, Suicide Attempt, Death, Abuse, Neglect, and Individual to Individual Abuse.

Note: Mandatory fields are marked with an asterisk. In addition, some fields are conditionally mandatory, or in other words, become mandatory based on the response to a previous field. All mandatory fields (including conditionally mandatory fields) must be completed on a screen.

Field Name	Field Description
Was there a hospitalization for this individual?	Select from the drop-down whether there was a hospitalization for the individual.
Date of Admission:	Enter the date of the individual's admission to the hospital.
Hospital name:	Enter the name of the hospital where the individual is admitted.
Admitting diagnosis:	Enter the diagnosis that the individual was admitted with.
Was the admission from the Emergency Room?	Select from the drop-down whether the individual was admitted to the hospital from the Emergency Room.
What occurred during the hospitalization? Include follow-up or referral information.	Select all of the treatments and activities from the checkbox list that occurred during the hospitalization (i.e. Admission to ICU/CCU, Restraint use, Surgical procedure, etc.).
If other, please specify:	If 'Other' was selected as a treatment or action that occurred during the hospitalization, describe what took place during the hospitalization.
Actual Date of Discharge:	Enter the date of the individual's discharge from the hospital.
Discharge diagnosis:	Enter the diagnosis that the individual was given upon discharge.
Did you get the discharge instructions upon discharge?	Select from the drop-down whether the individual was provided with discharge instructions at discharge.
What changed for this individual after discharge?	Select all of the changes from the checkbox list that occurred as a result of the hospitalization (i.e. Modification to the ISP, New medical condition, New treatment, etc.).
Describe the individual's current status:	Select the option or options from the checkbox list that describe the individual's status post discharge.
Was a follow-up appointment scheduled for post hospitalization with the medical professional?	Select the medical professional or professionals from the checkbox list that the individual has appointments with post hospitalization.
Add additional information not captured above:	Enter any additional information related to the hospitalization, discharge, and follow-up that is not captured above.