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 require the prescriber to enter a pass order ("Day Pass" or "Multi-Day Pass") indicating the expected timing for patient leaving and returning. Use of the “Leave of Absence” navigator is optional, as a reminder about the correct order to place.
Nursing will work directly with pharmacy to prepare medications for the pass duration according to the active orders. Nursing will use discretion to determine the amount of PRN medications required, unless specific amounts are specified by the attending through verbal communication or a nursing communication order.
Leave of Absence for Procedure
Inpatients at one facility may need to attend another facility for a procedure or test, with expectation of imminent return. Both settings may be on Connect Care and so all of a patient's documentation, orders and medications remain available in the shared record. Arrangements for patients going temporarily from a Connect Care site to a different Connect Care site, with expectation of return, can be managed with the "Leave of Absence" navigator (usually found in the Discharge activity).
Receiving site needs to attend to continuing inpatient orders or instructions
Use the "LOA Orders" section of the LOA Navigator to perform orders reconciliation for any medications or infusions that need to continue at the receiving site while the patient is absent from the sending site.
For the workflow needed before, during, and after the LOA to ensure medication continuity between the sending and receiving sites, see the guide (includes steps for prescribers and nurses/clerks).
If medication orders are required specifically for EMS transport, please place as an active PRN order with an appropriate start date and PRN reason of “for EMS”.
Enter and sign the Leave of Absence order.
Receiving site does NOT need to attend to continuing inpatient orders or instructions
The LOA Navigator does not need to be used if the patient does not require pass medications.
If medication orders are required specifically for EMS transport, please place as an active PRN order with an appropriate start date and PRN reason of “for EMS”.
Enter and sign the Leave of Absence order.
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.