As soon as you get close to discharge (day before!), start preparing. This includes ordering/discontinuing outpatient medications, starting the D/C Summary if you haven’t already, and organizing final recommendations from consults/oxygen requirements/tube feeds/etc.
Basic steps for discharges:
D/C note –> Medication Reconciliation –> Free text the Clerk to set up follow-up appointments/order Outpatient follow-up labs –> Tell the Attending to sign your D/C Note –> Final D/C Order
Types of Discharges:
- Home: Follow the basic steps above.
- Outside Facility/Nursing home: Must complete a full D/C Summary prior to discharge. The social worker must have the printed, Attending-approved summary to fax. Make sure the meds are correct, then sign/initial every page with medications — that serves as the facility’s prescription orders.
- Expired: D/C summary still required. Remember to document the time of death, as well as the family’s wishes regarding autopsy. Select the “Expired” radio button on the D/C Note dialog box.