Discharge Disposition (Destination)
Patients may return to independent living (e.g., private residence) at discharge. However, many have needs that can only addressed within a health care facility. Different categories of facilities (e.g., continuing care, acute care, hospice, rehabilitation) have different requirements that must be met before a patient is accepted. Accordingly, it is important to be aware of an "Expected Discharge Disposition" as soon as possible, and to adjust transfer preparations accordingly.
Expected vs Actual Discharge Disposition
An "Expected discharge Disposition" can be entered directly within the discharge planning sidebar. When displayed in transition plans, the expected discharge disposition is interactive. Clicking on the hyper-linked destination description opens a pop-up editor for making quick changes to the expected disposition.
An "Actual Discharge Disposition" is entered at the time of discharge, usually as part of the discharge order. This value may be pre-seeded by a process for matchined expected dispositions to actual dispositions. Whether blank or defaulted at discharge, prescribers need to confirm that the actual discharge disposition is correct within the discharge order.
Expected Discharge Disposition Editor
The expected discharge disposition editing tool has the same appearance and functions, irrespective of whether it is viewed in the discharge planning sidebar, a pop-up editor, or within discharge navigators.
One or more of the following sections may appear:
Embedded Help
Hyperlinked "[?]" text can be clicked to access a quick explanations and tips related to setting discharge dispositions.Destination Type Pick-List
The drop-down lookup tool can be used to select from among a dozen types (categories) of discharge destination types (e.g., Group Home, Continuing Care facility).Destination Type Quick Buttons
Commonly selected destinations appear as quick-select buttons that will populate the destination type pick-list without opening that list.Pre-Admit Disposition
If an expected discharge destination type implies a destination facility, then an information block appears that pulls forward details about the type of facility, and facility name, where the patient resided pre-admission.Repatriation Order
If a RAAPID repatriation order has been placed and is active, a link appears to indicate this. Clicking on the link will open a pop-up display about the status of the repatriation request.Destination Facility
If an expected discharge destination type implies a destination facility, and the name of that facility is known, then a new pick-list appears that can be used to look up and select the specific facility. Note that different lists appear depending upon the selected type of destination.
Expected Discharge Disposition Patient List Columns
An Expected Discharge Disposition patient list column ("Exp Disch Disposition", column 3049463001) is part of the Rapid Rounds patient list template and can be added to any "My List" in the patient lists activity. The column has the following properties:
Display
The column displays icons (images) representing different types of discharge destination (e.g., Home, Continuing Care, etc.). If a patient is a "repatriation" candidate, a "return" icon shows in gray (out-of-zone patient eligible for repatriation to a home facility) or green (repatriation order already placed and in process).Hover
Hovering over a colum icon causes a hover bubble to display information relevant to the relevant patient's discharge disposition. This includes home community, pre-admission residence type, pre-admission facility name, expected residence type, expected residence name, status of any repatriation order and status of any anticiipatory inter-facility discharge order. Links are provided for immediatly initiating repatriatin and/or discharge orders.Double-click
Double clicking on one of the column icons (within a patient row) causes a popup editor to appear. This allows quick review and/or update of the expected discharge disposition, discharge destination and repatriation status.
Two additional columns are available to draw focused attention to a patient's repatriation or discharge order status:
Repatriation Order Status (3049463002)
Display
Coloured dot indicating that an inpatient is a repatriation candidate (out of zone; yellow) or has repatriation order placed (green).Hover
Popup display of expected discharge disposition information (same as for expected discharge disposition column).Double-click
Open expected discharge disposition editor (with access to repatriation information).
Discharge Order Status (30411230801)
Display
Discharge Order indicator of whether discharge order has been placed (green dot) in anticipation of inter-facility transfer.Hover
Popup display of expected discharge disposition information (same as for expected discharge disposition column).Double-click
Open chart to orders activity