Patient discharge

1. Patient discharge Chapter 20

2. objectives • Discharge a patient from the examination area • Complete open orders • Review the patient’s paperwork with the patient • Send the patient to the payment collections desk

3. Key Concepts • Patient discharge workflow • Out the door process • Open orders • Aftercare instructions

4. Discharge(Patient) • When physician finishes Out the Door process, open orders (incomplete orders) might need to be completed before discharging patient with patient’s paperwork from medical facility • Even though physician is seeing another patient the clinical staff might need to complete open orders in MedTrak • Patient Discharge Workflow step is important for these reasons: • Physician can focus on treating another patient without having to worry about whether any orders are missed for this patient • Clinical staff do not need to wait for physician to come out of an exam room to know what the physician wants them to do for the patient • Everyone in facility knows that everything will be done for a patient before the patient is discharged from the facility

5. Discharge(Patient) • The physician might have ordered a medication and if it was dispensed medication the clinical staff will need to take medication off the shelf record the lot number and give it to the patient • If it was a prescription the clinical staff might need to obtain physician’s signature on prescription before giving to patient • If patient was in medical facility for an injury/illness the clinical staff will need to give the patient his/her aftercare instructions • Go to Clinic Status screen • Do This! Pg. 249

6. Clinic Status Screen • Figure 20-1 • Place cursor in command field next to patient name click Open Orders button to see orders that need to be completed for the patient • Open Orders screen reflects what the clinical staff must do • Go to procedure screens for first three questions then enter “x” in each of answer fields enter MedTrak employee initials in Completed By answer field-Figure 20-2 • You can see answering each question and then clicking the Submit Answers button saves time • Next screen to appear is procedure screen for Appliance utilized question • Do This! Pg. 249

7. Procedure Screen • Figure 20-3 • Select appliance and enter “x” • Entering “x” is equivalent of “1” in quantity field • Click Submit button • MedTrak records the selection and automatically advance to the next procedure selection screen • Message appears at top of screen • Click Exit Screen button to go to next question screen in workflow for order • Select the next option by typing “x” in quantity field next to the option • Figure 20-4

8. Procedure screen • After making selection click Submit button • MedTrak records selection of option and automatically advances to next question screen for Dispensed supplies question • Select option by typing an “x” in quantity field next to option button • Figure 20-5 • Click Submit button to record selection • MedTrak automatically advances to next procedure screen and checks two conditions (rules) to see if patient is ready to be discharged: • Has the physician finished Out the Door process? • Are all open orders complete?

9. Procedure screen • If met MedTrak automatically prints the patient’s Aftercare Instructions, Prescriptions, and Visit Charges • Workflow STATUS column may display IN Prtg (instructions Printing) • Click Submit/Refresh button to refresh the screen which resets workflow STATUS to Disch • Figure 20-6 • ORDER column now displays DONE-indicating there were open orders which are now complete • Workflow STATUS column displays Disch to indicate that paperwork for this patient printed and is ready for review with patient Who can now be discharged from the medical facility Do This! Pg. 253

10. Procedure screen • To finish clinical portion of workflow clinical staff must: • Print patient’s paperwork, aftercare instructions, prescription(unless ) charges for visit(patient’s responsibility visit only) • Retrieve dispensed medication(if ordered) • Get the provider’s signature on any prescription forms (if prescribed) • Return to room to se patient • Review aftercare instructions with patient • Review medications with patient both prescription and dispensed • Review charges with patient(patient responsibility visits only) • Instruct patient to pay at front desk(patient responsibility visits only) • Discharge patient from Clinic Status screen

11. Clinic Status Screen Discharge • Place cursor in command field next to patient name and click Discharge button to display Discharging screen-Figure 20-7 • Enter your password in password entry field and click Submit button • If you have a global password just click Submit button • In real clinical setting clinical staff typically share computers so clinical staff will need to enter his/her employee password on this screen • Click Submit button • Click Status screen refreshes with patient moved to reception area (payment collection desk) for payment of services for the visit • Workflow Status is now Done • This notifies front desk person that charges for visit need to be reviewed with patient and reminds them to collect any monies due at this time • Figure 20-8 • Do This! Pg. 255

12. Printing the patient’s aftercare instructions, prescription, and visit charges • You will need to print and turn in aftercare instructions , prescriptions, visit charges documentation for patient that you completed in electronic health records • Do This! Pg. 255