Who does what in the discharge?

[albinotoad]

Hello All,

I would like to hear about the discharge process at your various facilities. Who does what? As the patients discharge nurse I may have JUST met this patient and am sending him home after a brief assessment and 9 am meds.

We give them prescriptions and a discharge packet with instructions on it and go over the prescriptions.

How do you know when to send them to a cardiologist or urologist or a wound care clinic? Does your doctor tell your case manager and they set it up?

We have had a communication breakdown regarding who is responsible for telling the patient where they need to go and give them the phone numbers for those specialists and referrals.

How is the day of discharge handled at your facility?

[R.NICU]

Hey. Sorry for the late response, but I've been M.I.A. d/t this last semester of school! omgoodness they are trying to kill us. anyway, that's another story, for another thread.

At my facility, you may have also just met the person for the first time and be d/c-ing them. I believe this is common at many hospitals regardless of the specialty. Where I work, we have weekly town meetings where we discuss the patient's progress and barriers to discharge. After everything is decided, the case manager facilitates where the patient is going, f/u appointments, getting equipment for the patient if needed, and pretty much anything else after d/c. The nurse goes over everything. We discuss PT, OT, ST, and nursing considerations and recommendations. We also have this annoying form that has to be filled out with all the patient's meds, what times we administered them at the hospital and what they are for, EVEN THOUGH MOST OF THIS INFO IS ON THEIR SCRIPTS! ugh! ((can you tell i've done too many discharges lately lol )) The sheet is very time consuming when you have alot of patients. So we go over the meds, go over f/u appointment dates and times, go over where/how they will get their equipment if applicable, and adv to contact case manager if they have questions post discharge. If it's hectic and i'm ready to d/c the patient but case mgmt is still working on some of their paperwork, I'll go over the therapy and nursing papers and the case manager finishes up the rest and sees the patient out.

So yes, case mgmt sets up the patient's appts at my facility. The patient can do it themselves if they like and then report it to us so we don't double schedule or cause confusion.