Leave of Absence (LOA)
When admitted patients leave an inpatient setting with expectation of return, they enter a "leave of absence" (LOA) status. The leave may support attendance at an event or pre-discharge assessment, with no care at another healthcare facility; or, the leave may allow attendance at a clinic or facility where a specific intervention can be provided.
Leave of Absence for Pass
Patients going on pass may need medications provided to cover for their needs while away. This is accomplished with the "Leave of Absence" Navigator found within the "Discharge" activity of an open inpatient chart. This navigator reminds about the correct order to place ("Day Pass" or "Multi-Day Pass") and the use of "LOA Orders" to arrange for pass medications.
The "Leave of Absence" Navigator (available to physicians on the "Discharge" activity in an inpatient chart) is only used for pass absences. Leaves to other facilities for interventions are handled without a navigator.
Leave of Absence for Procedure
Inpatients at one facility may need to attend another facility for a procedure or test. Both settings may be on Connect Care. The clinical information system does not allow simultaneous active encounters at two different locations at the same time. Accordingly, a variant of the Interfacility Transfer workflow is used.
Transfers for patients going temporarily from a Connect Care site to a different site, with expectation of return, are managed with a "Leave of Absence" order.
Physicians do not need to use a navigator if the patient does not require pass medications. If medications or other instructions are needed for EMS support during transport, enter requests as active PRN orders in the chart with an appropriate start date and a PRN reason of "For EMS".
Other members of the healthcare team use their own navigators to generate a Medication Administration Record and Interfacility Transfer Report.
Prescriber accountabilities are explained, with special considerations for procedure orders when the destination procedure site is not using Connect Care as its record of care:
Discharge from Leave of Absence
There are times when a patient on a Leave of Absence does not return. The patient may require an admission at another site if, for example, on LOA for a procedure, but following the procedure requires further care at the procedural site. Once it has been determined that the patient will not be returning, the patient should be discharged from their leave of absence.
Most of the associated workflow can be completed by nurses or ward clerks using their "Unit Manager" activity. Prescribers need to take care of discharge documentation, usually in the form of a discharge summary.