discharges

· Specify follow-up instructions

· Arrange follow-up & referrals

· HCCSS/CCAC/LHIN: PICC orders

· HCCSS/CCAC/LHIN: IV medication orders

· HCCSS/CCAC/LHIN: Foley & wound care orders

DISCHARGE CHECKLIST

⬜ Before discharging a patient - has your patient been cleared by the medical team AND by allied health? Is their caregiver aware and ready? Have home supports/equipment been secured? Is there a plan for follow-up?

⬜ Place discharge orders

⬜ Sign discharge scripts with your printed name, position and signature, and give them to the Unit Clerk who can fax to their pharmacy - not the patient

⬜ Complete & route your discharge summary to GP and relevant specialists

If the patient uses ODB (age >65, social assistance, or administered by home care): new prescriptions may need an LU (Limited Use) code

- Common drugs: PPIs, most DOACs/LMWHs, PO vancomycin

If from a shared living space (LTC, RH, group home): confirm if a COVID swab is needed within 24h before discharge, and if discharge scripts need to be faxed BEFORE discharge day for timely ordering/administration

If on a tightly supervised medication (methadone/Suboxone, depot antipsychotic, etc.): call their pharmacy/prescriber to notify them of doses received in hospital

· Specify follow-up instructions

Discharge Orders > order Follow-up with: and type the instructions for the patient

This will be printed in their discharge papers

· Arrange follow-up & referrals

To SJHH clinics:

IMRAC: Discharge Orders > order Ambulatory referral to IMRAC
Firestone (COPD clinic): Discharge Orders > order Ambulatory referral to COPD Discharge Follow-up Clinic
Diabetes clinic (West 5th): Discharge Orders > Ambulatory referral to Diabetes Services

To other clinics: click here for selected referral forms

To specific SJHH providers: check the chart if the service/provider indicated if they will book follow-up themselves; if not, route your discharge note to that specialist and consider contacting them.

To specific non-SJHH providers: fax a paper referral form (find the fax number on CPSO) and route your discharge note. Include the MRP’s contact info in case the referral is rejected or incomplete.

· HCCSS/CCAC/LHIN: PICC orders

* These are done on paper and then faxed to the HCCSS office

Find the Vascular Access Devices order form - found here
Place patient sticker in the top right corner
Fill in the diagnosis then all the boxes in 'Vascular Access Insertion Information'

All of the PICC information is found in the Summary tab > Lines, Drains, Airways

Check off the appropriate box for Flushing Solution, Final Locking Solution and Dressing Change - usually the first options suffice
Sign and date the end of the form

· HCCSS/CCAC/LHIN: IV medication orders

* These are done on paper and then faxed to the HCCSS office

Find the Home Infusion Therapy Prescription form - found here

For IV vancomycin/aminoglycosides, click here

Place patient sticker near the top
Fill in the medication details

You must indicate the last inpatient dose as requested, to avoid gaps in administration

Sign and date the end of the form

· HCCSS/CCAC/LHIN: Foley & wound care orders

* These are done on paper and then faxed to the HCCSS office

Find the General Medical Orders form - found here
Place patient sticker near the top
Fill in the medical orders near the bottom of the page

Foley order - check off the '⬜ Indwelling Urinary Catheter Care' box and indicate the insertion date, size (Fr) and material/type (found in Summary tab > Lines/Drains/Airways)
Wound care order - find the current wound care order in the patient's inpatient orders, and duplicate the same order in the form

Sign and date the end of the form

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