If a patient is readmitted within 48 hours of discharge from a resident service, they should return to the primary team who discharged the patient UNLESS:
- It is an intern resitern day for the primary team or
- The discharging team is post-call, and all members have left for the day.
If the patient cannot return to the primary team, they should be admitted by the on-call housestaff service. If the admitting housestaff team is capped, then the bounceback patient will be admitted by the on-call GENS DF or the MROC. The patient will be given as a holdover to the discharging team the following day.
Generally, bounceback patients are not counted toward resident admitting caps. Transfer back to the primary team can be discussed the following day with the guidance of the CROC and involved attendings if needed.
There is no perfect set of rules for bouncebacks. If there is any confusion on this situation, please page the CROC.
These rules have been agreed upon with the hospitalists. Under no circumstances should the hospitalists admit a resident team bounceback (within 48 hours of discharge). Accordingly, residents should not admit hospitalist bounebacks that occur within 48 hours of discharge.
Updated: November, 2013