Inpatient—The pre-admission medication list (PAML) remains open and available for editing for as long a the patient remains on the inpatient census. When the patient is discharged from the inpatient census, the PAML is queued for closing due to discharge. If the patient does not return to the inpatient census within 30 days, the PAML is closed automatically.
Patient readmitted within 30 days—If a patient is readmitted within 30 days of discharge, the PAML remains open and available for editing. The PAML is removed from the queue for closing due to discharge. When the patient is once again discharged, the PAML is queued for closing, 30 days from the most recent discharge.
Patient transferred between MGH and BWH within 30 days—Discharge from one institution and admission to the other is handled the same as readmission within 30 days of discharge. This applies to both MGH and BWH. Identification for the institution (the MRN and logos on the displays and printed form) is based on the site from which the PAML was opened. For the stand-alone PAML builder, the site is determined by the selection made by the clinician when looking up the patient.
Patient with PAML started before admission, but not admitted—If a PAML is started but the patient is not admitted, the PAML is closed automatically, 30 days after the last update was signed. This includes a PAML started for a patient who is boarding in the Emergency Department, who is discharged from the ED rather than admitted to an inpatient unit..
Patient with PAML started in pre-operative area—By design, a PAML built in a pre-op area is not closed automatically, regardless of when the last update was signed.
Manual closing—On request of the clinician, an open PAML can be closed manually by Information Systems support staff.