DISCHARGE GUIDELINES
Discharge Procedures
In most cases, your main Attending Physician will inform you upon admission of the estimated duration of your hospital stay and the expected date of your discharge. When this is not possible, you will still be informed several days ahead of your expected discharge date.
Ask your doctor when he would be able to write the discharge orders because this will trigger all other hospital procedures such as the preparation and issuance of discharge instructions, reconciliation of your medications and computation of the final bill.
Discharge procedures must be completed before 11 am to avoid extra charges. A full day rate is levied if patients leave after 5:00 pm.
Discharge Planning
Plan early to reduce your chances of being readmitted and increase your chances for a healthy recovery. Take steps as soon as possible during your stay to plan for a successful transition from the hospital. To begin, ask to speak with your physician, and review the following:
- Your discharge summary and discharge plan
- Your complete medicine list and instructions
- Your upcoming appointments
- What to do if you don’t feel well.
Safe Discharge from Hospital
- Always make sure at least one family member or friend is present when you review your specific discharge instructions with your doctor and nurse.
- Discuss with both your doctor and your nurse what you can generally expect the first few days and weeks at home, given your circumstances.
- What are the signs of infection you may have – either intestinal or at a surgical site?
- When can you expect to resume your normal routine?
- How mobile will you be or should you be?
- Are sleep disturbances, night sweats, lack of appetite, or other physical symptoms normal reactions for your situation in response to surgery, treatment, or anesthesia?
- Are feeling of anxiety, restlessness, and depression (within reason) common emotional reactions in your doctor’s experience, given what you might have with your illness or injury?
- What would be a red flag, abnormal events, or side effects that would cause for alarm in your situation? Whom should you contact
- Review instructions for surgical site care.
- Can you bathe? If so, how? Should you panic if your wound gets wet? What should you do in that case?
- Review. Practice with your nurse and/or doctor care instructions until you completely understand them.
- What physical symptoms would be causes for concern? What would your doctor want you to do in that case?
- What is the plan for removal of any stitches, staples, etc.?
- Review instructions for the proper care of any invasive medical devices like drains, ports, and the like, which need to be closely monitored and cared for, as any break in the skin barrier (an entry site for bacteria) makes you more susceptible to infection.
- Make sure you completely and fully understand how to properly clean, change and monitor devices that remain in you or are attached to you. Go over care instructions with your nurse until you completely understand what you are supposed to do.
- What would be a red flag that something is wrong – such as an infection, leakage or blockage? What should you do if something like that occurs?
- Make sure you really understand instructions for all medications that are to be continued at home. Check and double-check the following:
- Have any changes in your medications been reviewed by your doctor or nurse?
- Have all medication labels been double-checked agains written discharge instructions?
- Are there standard side effects you can expect for specific medications? What is an abnormal or adverse reaction to each of the medications you have been prescribed?
- How should medication be taken – with food, on an empty stomach, first thing in the morning?
- Is there a special protocol or plan for pain management? What should you do if you feel that your pain is getting away from you?
- Get a pill organizer to sort medications.
- Get your prescriptions filled before you leave the hospital. Make sure you leave the hospital with at least one-day supply of all medications if you are filling your prescriptions once you get home.
- Prepare as much as possible before you go to the hospital for special aftercare needs – special medical equipment, hospital bed, supplies, devices. Find out what your insurance will cover. Have a hospital social worker help you.
- Set up a “recovery bedroom” if you must avoid stairs.
- Rent a hospital bed, if necessary, and have it set up before you get home.
- Arrange to rent or purchase any other medical equipment or supplies that might be helpful or necessary.
- Create meal plans, to-do lists, and list of bills to be paid, etc., so friends and family know how to help
- Get a stack of books you’d like to read or DVDs to watch.
- If you have a family or primary care physician, make sure that your AHMC physician communicates with him/her verbally or in writing to ensure continuity of your care. Make sure all important reports, tests, and discharge summaries are sent to him/her
- Will you have enough family support at home to help you for both routine tasks like meals, and aftercare tasks like helping you get around, sorting meds, getting you to follow up doctor and therapy visits, and the like.
- Arrange transportation home.
- Will you need an ambulance service? Will insurance pay for it, or if not, a car service? If not, arrange for a ride from a car service, or ask a relative to take you home.
- Try to arrange for the least taxing method and route to make the trip home.
- Set up a home visit with your priest or pastor, imam, or any other spiritual advisor, if that would be helpful to you.
- Get contact numbers and e-mail addresses for pain care and other emergency questions.
- Schedule all follow-up doctor visits (you may have several doctors to see) before you leave the hospital.
- Request all your hospital medical records now. These may include:
- Discharge summaries
- Laboratory and imaging results
- Pathology reports
- CT and MRI scans
- Surgical Reports