Discharge as Deceased Navigator

A unique patient navigation workflow is needed when a patient dies in a healthcare facility, including when they are declared dead on arrival at the facility. This "patient movement" is a form of discharge, with death bringing the associated healthcare encounter to an end. The workflow is supported with a navigator.

Discharge as Deceased Navigator

A "Discharge as Deceased" navigator is found within the Discharge activity, with slight variations in how the navigator is initiated for emergency department encounters.

  • Emergency department

    • With a patient chart open and the "Dispo" activity selected, find the "Disposition" section and enter a disposition fitting the death circumstance (e.g., died in ED).

    • This will reveal a new section in the Dispo activity called "Death Documentation". Select the section link to open the "Discharge as Deceased" navigator.

  • Inpatient departments

    • With a patient chart open and the "Discharge" activity selected, look for and select the tab labelled "Discharge as Deceased".

The following information relates to tasks that prescribers must complete, guided by the navigator.

Essential Steps for Prescribers

The Discharge as Deceased navigator is available to all clinicians. Some sections are best completed by non-prescribers. Other actions can only be completed by attending prescribers. Clinicians must attend to:

  • Date/Time/Cause of Death

  • Criteria for Organ Donation

  • Criteria for Corneal Donation

  • Criteria for Medical Examiner's Review

  • Criteria for Autopsy

In addition, unsigned and unneeded orders should be cleaned up, and a discharge order (with death entered as disposition) should be entered before completing a discharge summary using a provincially standardized template.

Death Certificates

The Province of Alberta is working on, but does not yet support, digital death certification. At this time, responsible physicians must complete a formal (paper) death certificate in the event of a patient death. These can be found at Emergency or Nursing Station forms stores. They can also be obtained from the facility admitting department and must be returned to medical records before a body can be released.

Autopsy Consents

Prescribers and/or families may request an autopsy. This possibility is covered by a section within the "Discharge as Deceased" navigator where autopsy-related information is entered and guidance is provided. If an autopsy is requested, family consent should be obtained. Like death certification, such consents are currently paper-based. Instructions are provided within the navigator for how to find, complete, print and sign the requisite form.