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HOW TO PREFORM A GOOD DISCHARGE

HOW TO PREFORM A GOOD DISCHARGE. Jason Haag Intern Conference. Before Discharge. Plan ahead Use Resident Assistants to Make follow up appointments On WebCis f/u lists Fax discharge summaries/patient information. Before Discharge. Plan ahead Talk to your patient

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HOW TO PREFORM A GOOD DISCHARGE

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  1. HOW TO PREFORM A GOOD DISCHARGE Jason Haag Intern Conference

  2. Before Discharge • Plan ahead • Use Resident Assistants to • Make follow up appointments • On WebCis f/u lists • Fax discharge summaries/patient information

  3. Before Discharge • Plan ahead • Talk to your patient • How do they pay for meds? • Who is going to pick them out? • How long will the hospital stay be? • Who do they live with at home? • Do they have home health/home PT already in place?

  4. Before Discharge • Start your discharge summary • Can put in procedures • Secondary diagnosis • Follow up appointments • Pertinent labs • Start the hospital course

  5. Discharge Day • Brief Discharge Summary • Most important take home message to patients • Diagnosis • what you have/had done • Medications • ***reconciled with home list*** • Discharge instructions • What to do/what to look out for • Follow up appointments • Does not have to be exact date

  6. Discharge Day • Talk with Social Worker • Be very nice to these people… • About • Ride • They can provide one (ambulance, taxi, bus) • Medications • They can help pay for them (pharm assistance) • Home Health/Home PT • They can arrange it

  7. Discharge Day • Talk with the Nurses • Keep them in the loop • Nurses will provide • Patient education • How do I administer lovenox, do accuchecks? • They will decipher your discharge summary into patient talk • Make sure they understand what’s going on with the patient

  8. Discharge Day • Talk with Home Infusion • Talk early and often • They provide home IV therapy • Can arrange IV therapy on Saturday • Can arrange acute changes in antibiotic choice • IF they know about the patient ahead of time

  9. Discharge Day • Communicate with PCP • Don’t have to call • Send phone message with dx/tx • Not a novel (they can read your d/c summary), just give them a heads up

  10. Discharge Day • TALK WITH THE PATIENT!!!!!!!!! • They will have questions that they want their doctor to answer • The more time you put in early in the day answering questions will save you later

  11. Discharge Summary • Key Points • Carry over all diagnosis • Reconcile medication list • Procedures/imaging • No need to list every CXR, KUB • Pertinent Labs • Admission Chem-10, CBC • Special labs

  12. Discharge Summary • Hospital Course • List by problems • Overview of hospitalization • Not on HD#1…then on HD#2… • Express the maximum amount of information in the minimum amount of space • Be clear, concise, and coherent • The longer it is, the less likely someone is to read it

  13. Discharge Summary • Must do Brief Discharge Summary • To dictate or not to dictate • +/- of dictation • If you start falling behind • They will find you… • Medical Records keeps a log of physician of record and will track you down for delinquent d/c summaries • If you are too delinquent they won’t let you work (i.e. won’t pay you) till your caught up

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