Grady - Arrival Process
MEMO: Arrival Process at Grady
 
Date: November 17, 2025
Subject: EMS Pre-Arrival Reports, Activations, and Registration
 
Dear Valued EMS Partners,
 
That you and your crews for all that you do. Below is an outline of the arrival process at Grady with an explanation as to “why” we have these processes in place. This may serve as a friendly reminder, or it may be entirely new to you. By gaining a better understanding of the “why” we can streamline patient care and improve outcomes together.
 
The arrival process at Grady is different than the arrival process at other hospitals. This is due to our extremely high volumes. Grady is the busiest hospital in the state of Georgia and one of the busiest trauma centers in the nation. Grady sees around 55,000 EMS patients per year. Therefore, the activation and registration process must be very methodical.
 
EMS Pre-Arrival Reports:
En-route to Grady, EMS should call the PCC via phone to give a pre-arrival report. If flight EMS is unable to call on the phone, they may give a radio report to the PCC.
 
Grady prefers that EMS use the MIST (M- MOI/CC, age, sex, weight, I-injuries, time of injury, S-signs/symptoms, vitals, significant changes, T-Treatment) report format for pre-arrival reports and bedside patient handoff reports.
 
PCC staff may ask EMS questions during the pre-arrival report. Please answer any questions that the PCC asks during the pre-arrival report as more information may be needed to help determine patient activation level and/or to expedite the patient registration process for pre-arrival. The PCC may ask you for registration information during the pre-arrival report. Registering the patient pre-arrival expedites the care process for critical patients. (Please see the “Express Registration” section below for more details.)
 
To improve efficiency and streamline patient care, at the end of the pre-arrival report, the PCC staff will advise EMS where to go on arrival:  registration, express registration, or directly to a room or treatment area.
 
 
  • PCC direct line: 404-616-4677
 
Activations:
Activation patients must be correctly identified to ensure quick and appropriate care response. Over or under triage costs the hospital and patients time, money, and wastes precious resources as we have a limited number of OR's and specialty teams available. PCC staff may ask questions or request further information during the pre-arrival report to help determine the type and level of activation (Trauma, Burn, Stroke, STEMI). Once the activation and level of activation are determined, PCC staff will advise EMS whether they need to register, express register, or proceed straight to a room or treatment area upon arrival. Following the directions provided by the PCC on where to proceed upon arrival is crucial for patient care. Not following directions given by PCC staff during the pre-arrival report can be detrimental, causing delays in patient care.
 
Registration:
Stable EMS patients will go to registration and ambulance triage on arrival. If a patient is not an activation, the EMS crew should get in line (if there is one) and wait to register the patient before getting triaged and being assigned a room.
 
Express Registration - This is a process by which stable activation patients are registered prior to going back to MTC. All patients must be registered in the system and have an MRN prior to any treatment.
 
Statpacks are available for true unidentifiable "John or Jane Doe" patients. Avoiding the use of statpacks decreases patient harm. If an unresponsive patient can be identified, their medical records can usually be located, helping to avoid critical medication errors and giving better clues as to root causes of illness or injury. 
 
 
Thank you for your cooperation and dedication to improving patient care. I have attached a copy of the memo to this email. Please share this with any relevant stakeholders. Please feel free to reach out with any questions or concerns. Stay safe out there!
 

Best Regards,
Miranda Baras

Miranda Baras
EMS Liaison Manager
Grady Trauma Program
Cell: 770-374-5874