SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build

SGHI FHIR Profile Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions

CodeSystem: SGHI Admission Code System

Official URL: https://fhir.slade360.co.ke/fhir/CodeSystem/admission-codesystem Version: 0.1.0
Active as of 2026-09-15 Computable Name: SGHIAdmissionCodeSystem

A code system enumerating the concepts used to request, triage, place and track an inpatient admission across SGHI's environment.

This Code system is referenced in the content logical definition of the following value sets:

Properties

This code system defines the following properties for its concepts

NameCodeURITypeDescription
care-rank care-rank https://fhir.slade360.co.ke/fhir/concept-properties#care-rank integer Ordinal intensity of a level of care. A request outranking what a ward can nurse is a warning, not a block.
ours-to-fix ours-to-fix https://fhir.slade360.co.ke/fhir/concept-properties#ours-to-fix boolean True where the outcome was within the hospital's control, and so worth counting and acting on.

Concepts

This case-sensitive code system https://fhir.slade360.co.ke/fhir/CodeSystem/admission-codesystem defines the following codes:

CodeDisplayDefinitioncare-rankours-to-fix
emergency Emergency An unplanned admission for a patient needing immediate care.
elective Elective A planned admission, usually booked in advance.
transfer-in Transfer in An admission of a patient arriving from another facility or ward on a referral.
maternity Maternity An admission for labour, delivery or antenatal care.
newborn Newborn An admission of a baby born in, or brought in with, the mother whose stay it attaches to.
day-case Day case An admission expected to be admitted and discharged the same day.
inter-ward-transfer Inter-ward transfer The patient came from another ward within this facility.
direct-admission Direct admission The patient was admitted directly, without passing through an emergency or outpatient department.
general General Ward-level nursing care. 1
high-dependency High dependency Closer monitoring and nursing than a general ward provides, short of intensive care. 2
intensive-care Intensive care Organ support and continuous monitoring. 3
semi-private Semi private A room shared by a small number of patients.
private Private A single-occupancy room.
isolation Isolation A room that isolates a patient for infection control.
delivery Delivery A room equipped for labour and delivery.
procedure Procedure A room equipped for bedside procedures.
amenity Amenity A room offering additional comfort beyond clinical need.
resuscitation Resuscitation A bay equipped for resuscitation.
open-bay Open bay A bed that belongs to no room.
paediatric Paediatric A ward that nurses children.
theatre-recovery Theatre recovery A post-anaesthetic recovery area, where a patient is monitored after theatre before returning to a ward.
near-nurses-station Near the nurses' station A bed within close sight of the nursing station.
side-room Side room / privacy A side room, asked for on privacy grounds.
step-free Ground floor / step-free A bed reachable without stairs.
self-pay Cash The patient pays directly.
insurance Insurance A payer covers the admission, subject to eligibility and benefits.
mpesa M-PESA Mobile money.
cash Cash Physical cash.
card Card Debit or credit card.
bank-transfer Bank transfer Transfer from a bank account.
wallet Wallet A stored-value wallet held for the patient.
no-deposit-emergency Emergency admission, collect after stabilisation An unresolved payer holds the bill, never the bed.
no-deposit-charity Charity or sponsored patient A charity or sponsor is expected to settle the account.
no-deposit-waived Deposit waived by an administrator An administrator has waived the deposit.
no-deposit-corporate Corporate account on file A corporate account will be billed.
preauth-draft Draft Prepared but not sent to the payer.
preauth-pending Pending Submitted and awaiting the payer's decision.
preauth-approved Approved Approved, carrying a reference and an approved amount.
preauth-declined Declined Declined, carrying a reason.
consent-by-patient Given by the patient The patient consented for themselves.
consent-by-guardian Given by a guardian or next of kin A guardian or next of kin consented on the patient's behalf.
consent-emergency Treated under emergency provisions Treatment proceeded under emergency provisions without consent.
identified Identified The patient can be named and matched to a record.
unidentified Not identified The patient cannot yet be named. A patient with no name is still admissible.
age-infant Infant Apparent age band: infant.
age-child Child Apparent age band: child.
age-teenager Teenager Apparent age band: teenager.
age-young-adult Young adult Apparent age band: young adult.
age-middle-aged Middle aged Apparent age band: middle aged.
age-elderly Elderly Apparent age band: elderly.
arrived-ambulance By ambulance Brought in by ambulance.
arrived-carried Carried in Carried in.
arrived-walked-collapsed Walked in and collapsed Walked in under their own power and collapsed.
arrived-police Police Brought in by police.
arrived-bystanders Brought by bystanders Brought in by members of the public.
deferred-identity Identity and health ID Identity and health ID, once someone can confirm them.
deferred-next-of-kin Next of kin and contact details Next of kin and contact details.
deferred-billing Billing type, payer and eligibility Billing type, payer and eligibility.
deferred-diagnosis Full admitting diagnosis and care plan Full admitting diagnosis and care plan.
break-glass-unconscious Patient cannot consent The patient is unable to consent to access.
break-glass-life-threat Immediate threat to life Access is needed to answer an immediate threat to life.
break-glass-covering Covering another clinician Accessing while covering for the assigned clinician.
break-glass-identity Confirming identity Access is needed to confirm who the patient is.
refer Refer Refer the patient onward rather than admit.
admit Admit Admit the patient.
admit-now Admit now Admit immediately.
book-for-date Book for a date Book the admission for a future date.
admitted-in-error Admitted in error The admission should not have been raised.
duplicate-admission Duplicate admission A duplicate of another request. true
patient-declined Patient declined admission The patient declined to be admitted.
treated-and-sent-home Treated and sent home instead The patient was treated and discharged without admission.
moved-to-another-facility Moved to another facility The patient was moved to another facility.
ward-cannot-receive Ward cannot receive the patient The receiving ward could not take the patient.
improved Treated and improved The patient improved and no longer needs admitting. false
referred-out Referred out instead The patient was referred elsewhere instead. false
went-elsewhere Went to another hospital The patient went to another hospital while waiting. true
refused Patient refused admission The patient refused admission. false
died-waiting Died while waiting The patient died before a bed was found. A closed record, not a reversible decision. true
defer-no-bed No bed available Deferred because no bed was available.
defer-patient-not-ready Patient not ready Deferred because the patient was not ready.
defer-theatre Surgeon or theatre unavailable Deferred because the surgeon or theatre was unavailable.
defer-payer Payer approval outstanding Deferred pending payer approval.
defer-patient-requested Patient requested Deferred at the patient's request.
at-emergency-department Emergency department Waiting in the emergency department.
at-outpatient Outpatient area Waiting in an outpatient area.
at-corridor-trolley Corridor trolley Waiting on a trolley in a corridor.
at-another-ward Another ward Waiting on another ward.
at-home At home Waiting at home.
at-theatre In theatre In theatre.
at-another-facility Another facility At another facility.
ready Ready Nothing outstanding.
needs-attention Needs attention Something is outstanding but the admission can proceed.
not-ready Not ready Blocked until something is resolved.
requested Waiting admission Requested and waiting for a bed or a decision.
scheduled Scheduled Booked for a future date and not yet arrived.
admitted Admitted Admitted. A patient admitted before a bed is free waits under 'needs bed', which is a view over this state rather than a state of its own.
discharge-pending Discharge pending Discharge decided and in progress.
discharged Discharged The stay has ended.
cancelled Cancelled The request left the queue without an admission.
removed-in-error Created by mistake The ward record should never have been created.
removed-duplicate Duplicate of an existing ward The same ward is already set up under another record.
removed-wrong-facility Wrong facility The ward was set up against the wrong facility.
removed-test-data Test or training data The ward was created for testing or training and is not a real ward.
removed-ward-cancelled Set up before the ward was cancelled The ward was configured in advance of opening, and the plan to open it was then dropped.
removed-other Other A reason none of the others covers. Expects a written explanation alongside it, since the code alone says nothing.
eating-drinking-normally Eating and drinking normally The patient is taking food and fluid as they normally would.
fluids-only Taking fluids only The patient is tolerating fluids but not yet solid food.
small-amounts Taking small amounts The patient is taking some food and fluid, below what they need.
not-tolerating-oral-intake Not tolerating oral intake The patient is not keeping food or fluid down, which is a reason to question the discharge.
independent Independent The patient moves without help and without an aid.
walking-aid Walking with a stick or frame The patient moves without another person but relies on an aid.
needs-one-assist Needs one person to assist One person is needed to move the patient safely, which is what home has to provide.
needs-two-assist Needs two people to assist Two people are needed to move the patient safely.
bed-bound Bed bound The patient cannot be got out of bed.
pain-free Pain free The patient reports no pain.
controlled-on-oral-analgesia Controlled on oral analgesia Pain is held by medicine the patient can take at home.
controlled-needs-review Controlled but needs review Pain is held for now, but the regimen is expected to need changing.
not-controlled Not controlled Pain is not held, which is a reason to question the discharge.
condition-recovered Recovered The problem the patient was admitted for has resolved.
condition-improved Improved The patient is better than on admission without having fully recovered.
condition-unchanged Unchanged The patient is no different from how they arrived.
condition-worse Worse The patient is worse than on admission.
condition-palliative Palliative Care has moved to comfort rather than cure.
spouse Spouse The patient's husband or wife.
parent Parent The patient's mother or father.
child Child The patient's son or daughter.
sibling Sibling The patient's brother or sister.
guardian Guardian Somebody with legal responsibility for the patient.
other-relative Other relative A relative none of the narrower codes name.
neighbour-or-friend Neighbour or friend Somebody close to the patient who is not a relative, and routinely the person actually taking them home.
explained-to-patient Explained to the patient The medicines were gone through with the patient alone.
explained-to-next-of-kin Explained to the next of kin The medicines were gone through with the next of kin, which is what happens where the patient cannot take it in.
explained-to-both Explained to both The medicines were gone through with the patient and the next of kin together.
not-explained Not explained Nobody was taken through the medicines. A stated answer rather than a blank, because a blank reads as an oversight and this may be a decision.
settled-in-full Settled in full Nothing is owed.
scheme-covered Covered by insurance or scheme The account sits with a payer rather than with the patient.
part-payment-balance-on-account Part payment taken, balance on account Something was paid at the counter and the rest is carried against the account.
waiver-approved Waiver approved The balance was written off, with approval.
referred-to-credit-control Referred to credit control The account was passed to credit control to pursue, and the patient is not held for it.
normal Normal The patient was discharged as planned, on clinical grounds.
transfer-out Transfer out The patient was moved to another facility, which takes over their care.
left-against-medical-advice Left against medical advice The patient chose to leave before the clinician judged them ready, and signed to say so.
absconded Absconded The patient left unobserved. Nobody discharged them, so the record carries the last time they were seen rather than a signature.
deceased Deceased The stay ended in a death. The facts of it live on the record of death.
home-with-community-follow-up Home with community follow-up The patient went home with a community health worker or a home visit arranged.
outpatient-clinic-follow-up Outpatient clinic follow-up The patient went home with a clinic appointment arranged to continue their care.
override-cashier-off-duty Cashier off duty, out of hours Nobody was at the counter to clear the account, and the patient is not being held for it.
override-leaving-against-advice Patient leaving against advice and will not wait The patient is going regardless, so the check cannot be completed first.
override-transfer-time-critical Transfer is time-critical The patient has to move now, and waiting for the check would cost more than skipping it.
override-signer-unavailable Signing person unavailable and patient must not be held Whoever normally signs this could not be reached, and holding the patient was judged the greater harm.
override-system-unavailable System or record unavailable at the time The information the check needs could not be reached when it was needed.
override-other Other A reason none of the others covers. Expects a written explanation alongside it, since the code alone says nothing.