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Discharge to the Community

This document is a summarised version of OP-CC5-Discharge. The summary has been created to be Emergency Department specific, and has been endorsed by the ED Leadership Team. Staff should review the PPG if they require further information.

Overview

This QRG aims to provide staff with the relevant information for discharging a patient from the Emergency Department, implementing a standard approach. Discharging of a patient is a multidisciplinary approach involving necessary arrangement made between the patient, the care provider & those who support the care for the patient outside of the hospital.

Applicability

This QRG applies to all presentations to the Emergency Department who are discharged to the community.

Responsibility

It is the responsibility of the Nurse Unit Managers and Directors of the Emergency Departments of each site to ensure the relevant staff are familiar with this QRG, that it is implemented according to the guidelines as outlined within, and that there is compliance by all staff members.

Guideline Details

Communication with the patient and their family/carer:

Just prior to the point of discharge the clinicians involved in the care of the patient should engage in a discharge conversation, with the patient, their family members, or carers. The conversation should aim to confirm that the relevant persons understand what has occurred during the Emergency Department stay, detailing;

  • Their diagnosis and what treatment they have received.
  • Their ongoing medication and treatment plan.
  • Their follow-up plan outside of the Emergency Department.
  • Their plans for transport home.

What does this look like in practice?

  • Is the patient safe for discharge home?
    • The responsible medical staff have indicated that the patient is safe for discharge home.
    • If indicated, ACE have cleared the patient for discharge.
    • The patient is stable.
  • Communication:
    • All patients should receive a discharge letter.
    • Provide a script if needed (and an IRCMAC form if new medications are to be given to a patient returning to a nursing home), and any brought medications are returned to the patient.
    • Appropriate follow-up has been arranged.
    • Provide patient with education as need. Allow patient & carers to ask questions.
    • Nurse to phone relevant care facility or family to inform patient is returning.
  • Practicalities:
    • Provide any aids as needed (crutches, dressings, etc.)
    • Return all medications and valuables.
    • Has transport been arranged?
  • Documentation:
Table 1: Pre-Discharge Check-List
·         Discharge letter provided

·         Script provided (+ IRCMAC form if returning to nursing home)

·         Follow up appointments arranged

·         Safe method of transport arranged (call friend, family, or nursing home if needed)

·         Cleared by ACE if assessment indicated

·         Do they require aids such as crutches?

·         Final set of vital signs

·         Remove line & devices

 

Supporting Documents

  1. OP-CC5-Discharge

Document Governance

Title: Discharge to the Community
Version: 2.0
Date Published: June, 2022
Date of scheduled review: 01/06/2024
Author: ED Leadership Team Approver: ED Leadership Team
Reviewed By: Ian Law Date: 07/06/2023
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