Inpatient Admission, Discharge & Transfer (ADT)

1. Overview & Business Value#

This comprehensive operational guide details the architecture, business workflows, configuration parameters, and execution steps for Inpatient Admission, Discharge & Transfer (ADT) within SmartERP.

Manage the full inpatient lifecycle from physician admission orders to ward transfers, clinical discharge summaries, and bed clearance.

{screenshot:inpatient-admission-discharge-transfer-adt-overview-dashboard}

2. Prerequisites & Security Access Groups#

• Required Modules: smarterp_healthcare, smarterp_clinical_core, smarterp_pharmacy
• Security Groups:
  • Healthcare Receptionist (Technical ID: smarterp_healthcare.group_medical_receptionist)
  • Physician / Attending Doctor (Technical ID: smarterp_healthcare.group_medical_doctor)
  • Pharmacy Dispenser (Technical ID: smarterp_healthcare.group_medical_pharmacist)
• Master Data Dependencies: Patient master registry (Medical Record Number - MRN), EFDA drug formulary, Ethiopian Ministry of Health (MoH) HMIS disease codes, and EHIS insurance tariffs.

3. Step-by-Step Configuration & Execution#

Step 1: Navigating to the Module Interface#

1. Log into your SmartERP instance at https://smarterp.et/odoo.
2. Open the main App Switcher (grid icon in the top-left corner).
3. Select the Healthcare app icon.
4. From the top navigation bar, open Healthcare → Clinical Dashboard → OPD Triage / Inpatient ADT / EMR / Pharmacy Dispensing.

{screenshot:inpatient-admission-discharge-transfer-adt-app-switcher-navigation}

Step 2: Creating and Parameterizing Records#

1. Click the New button in the top-left control panel.
2. Complete the mandatory fields in the record form:
   • Medical Record Number (MRN) (Mandatory): Unique national health identifier or generated hospital record code
   • Patient Demographics (Mandatory): Full legal name, gender, date of birth, and Kebele residential location
   • Encounter Type (Mandatory): Outpatient (OPD), Inpatient (IPD), Emergency, or Triage consultation
   • Attending Physician (Mandatory): Licensed healthcare practitioner responsible for clinical encounter
3. Configure optional operational parameters and localized tags as required:
   • Insurance Provider & Policy (Optional): EHIS CBHI/SHI policy or corporate credit contract
   • Triage Vital Signs (Optional): Blood pressure, pulse rate, respiratory rate, temperature, and SpO2
   • ICD-11 / HMIS Diagnosis Code (Optional): Standardized diagnosis category for statutory health reporting
4. Click the Save icon in the control bar to commit the record.

{screenshot:inpatient-admission-discharge-transfer-adt-record-creation-form}

Step 3: Validating and Processing Transactions#

• State Transitions: Execute operational state progression (Reception / Triage → Consultation → Lab / Radiology → Prescription → Billing / Discharge).
• Ledger & System Impact: Patient billing registers medical service revenue, debits patient or insurance accounts receivable, and debits pharmaceutical inventory upon prescription dispensing.
• Audit Verification: Automated recording of author ID, timestamp, and immutable revision history.

{screenshot:inpatient-admission-discharge-transfer-adt-transaction-processing-state}

Inpatient Admission Order Workflow#

When an outpatient or emergency patient requires hospitalization, the physician issues an electronic Admission Order:

1. In the consultation or emergency encounter, navigate to Disposition and select Admit to Inpatient.
2. Specify the Target Ward Category (e.g., Medical Ward, Surgical Ward, Pediatric Ward, ICU, Maternity).
3. Record Admitting Diagnosis and Attending Consultant Physician.
4. Specify isolation requirements (e.g., Airborne Isolation, Contact Precautions, Standard Precautions).
5. Click Submit Admission Request. The request routes instantly to the Ward Warden and Nursing Bed Allocation portal.

Ward Bed Allocation & Patient Transfer#

1. Open Healthcare > Inpatient > Bed Allocation Desk.
2. Select the incoming admission request.
3. The interactive ward map displays real-time bed availability color-coded by gender, acuity, and maintenance status.
4. Select an available bed (e.g., Ward B / Room 204 / Bed 03).
5. Click Confirm Bed Assignment. The patient's status transitions to Admitted, and the bed status locks to Occupied.

Intra-Hospital Patient Transfers#

When clinical progression necessitates moving a patient (e.g., step-down from ICU to General Ward):

1. Open the active inpatient admission record and click Transfer Bed / Ward.
2. Select the Destination Ward and Target Bed.
3. Record the clinical justification and transferring physician approval.
4. The system updates the room rate accrual automatically at midnight based on the new ward pricing category.

Clinical Discharge Summary & Financial Clearance#

Discharge requires dual clinical and financial authorizations:

1. Clinical Discharge: The attending physician documents the final discharge summary:
   • Hospital course and surgical procedures performed.
   • Condition on discharge (Recovered, Improved, Unchanged, Referred, Absconded, Expired).
   • Discharge medications and follow-up appointment date.
2. Financial Clearance: Cashiers reconcile all pending laboratory, pharmacy, bed day, and procedure charges into the unified invoice.
3. Upon payment or insurance guarantee, the cashier clicks Issue Exit Clearance Pass.
4. The ward nurse marks the bed as Vacated - Needs Sanitization, initiating housekeeping turnover.

4. Advanced Configuration Points#

• Automated Actions & Scheduled Tasks (Crons):
  • Healthcare: Generate daily MoH HMIS aggregate tally (smarterp_healthcare.ir_cron_hmis_sync): Runs daily at 23:00 to prepare DHIS2 health data summaries
  • Pharmacy: Flag expiring EFDA medicine batches (smarterp_healthcare.ir_cron_fefo_expiry): Runs daily at 06:00 to alert dispensers of lots expiring within 60 days
• Custom Print Templates & Reports:
  • Official Patient Encounter Summary & Medical Certificate
  • Electronic Prescription Order Form (Model 19 Compliant)
  • Ethiopian Health Insurance Service (EHIS) Claim Dossier
  • Daily MoH Outpatient / Inpatient Morbidity Tally Sheet
• Multi-Company Rules: Record-level security isolation under Company 1 (Ashewa Technology Solutions S.C.), preventing cross-company ledger leakage across parent and subsidiary legal entities.

5. Comprehensive Troubleshooting Matrix#