Connect Care StreetSmarts - Discharge Workflows

This section summarizes recommendations about how to use Connect Care to support discharges from inpatient facilities. The focus is on prescriber accountabilities when tasks may be shared by more than one individual. Prescribers can hand off to one another while a discharge is anticipated and being prepared. Prescribers may also work in teams, including trainees, where tasks are assigned to different individuals.

Workflow Sequencing

Completing a full patient discharge can be surprisingly quick... if recommended admission and rounding workflows have been followed. Indeed, most of what goes in a discharge summary will be a byproduct of work done before discharge. The following steps and sequencing can be adapted to different work contexts.

1. Discharge Order

   • Enter a discharge order as soon as there is an agreed date and approximate time of discharge (see discharge/transition planning module). This will trigger important prompts to multidisciplinary team members and bed planning. Be sure to select an appropriate discharge disposition.

2. Review Discharge Status - Use the Discharge Navigator

   • Note and follow instructions, in the indicated order, at the top of the discharge navigator.

   • Note any outstanding or pending investigations.

   • Reconcile the hospital problem list, indicating which problems have been resolved and which remain active (see problem management skills).

3. Validate Discharge/Transition Plan

   • Use interactive charting to validate the patient's transition plan, including discharge destination and disposition, together with details of home care, oxygen or other arrangements.

4. Clean up standing orders, complete medication reconciliation and place discharge orders

   • Discontinue any recurring orders that could generate unwanted In-Basket messages post discharge.

   • Complete discharge medication reconciliation (easy if this was done at admission) of home, hospital, continued and discontinued meds.

5. Finalize followup arrangements and instructions and validate "after-visit summary"

   • Use the provided discharge navigator sections to add or edit any followup instructions for the patient or any disease or medication instructional materials.

   • Use the provided discharge navigator section to skim materials to be presented to the patient/family, confirming that they are consistent with the intended care plan.

6. Complete a Discharge Summary

• Use one of the provided links to create a Headings-only, Basic or Advanced discharge summary using a provincial standard template. The Advanced template works best if admission and rounding workflow recommendations have been followed.

Resources

• • Discharge Navigator

    • Tip: Discharge Navigator

    • Demo: Discharge Navigator

    • Manual: Discharge Navigator