Document

: QPMC-GL-MS-001
No.
DISCHARGE OF PATIENT Revision
Level
: 0

GUIDELINES Effective
Date
:
Page 2 of 4 Page :

I. Objectives

II. Scope

This shall apply to all medical, nursing service personnel including billing section.

III. Definition of Terms

IV. Reference
a) In Patient Control Procedure ( QPHO/CH-DP-NRS-005 Rev 3)
b) ICD 10 Guidelines

V. Responsibility and Authority

1. All Department Heads are responsible in the dissemination and implementation of the
Guidelines
2.

VI. Guideline Details

a. Physician writes “may go home” orders in the chart and the complete diagnosis with
corresponding ICD – 10 codes on the Clinical Cover Sheet
 Note: Shall there be multiple diagnoses, each shall be written in line with its corresponding
ICD 10 code. The primary diagnosis shall be ascribed to the number 1.

b. The nurse-on-duty (NOD) verifies and carries out doctor’s discharge orders that contain the “may
go home”, home medications, follow up schedule (if applicable) and home care
instructions/advice.

c. The NOD and/or nursing attendant (NAOD) informs the patient and his/her representative
regarding the discharge order. He/she gives the Client Satisfaction Survey and explains how this
is filled up.

d. The NOD/NAOD enters the data needed for discharge in the BIZBOX-HIS and tags the patient
“may go home”

Prepared by Reviewed by Approved by

Miriam V. Ribac, RN

Marissa M. Mamate, MD Marissa M. Mamate, MD MARGARET JEAN DE GUZMAN, MD, FPSFP

OIC Chief of Hospital III
 Document
: QPMC-GL-MS-001
No.
DISCHARGE OF PATIENT Revision
Level
: 0

GUIDELINES Effective
Date
:
Page 3 of 4 Page :

e. The NOD encodes the diagnosis/diagnoses and its / their corresponding ICD 10 code/s in the
BIZBOX-HIS.

f. The NOD/NAOD fills up the Discharge Clearance Form.

 Note: For patient who undergone a surgical procedure, the completed operative record with
RVS code is attached to the Discharge Clearance Form.

g. A nurse station unit personnel (NOD /NAOD / IW / IT) brings the Discharge Clearance Form (with
attached operative record, as necessary) to the Pharmacy and Central Sterile Supply Room for
initialing. He/she returns the unused medicines and supplies.

h. The Discharge Clearance Form with attached operative record, as necessary is left to the
following services for processing:
i. PhilHealth (PHIC) Portal
ii. Billing Section – generates the Statement of Account (SOA).
 Note: The required data of a patient classified as NBB in accordance with
NBB Policy of the PHIC, who availed an On-Call Physician Service, will be
documented in the designated logbook for monitoring.
 For Patient with excess Bill after outright deduction of Philhealth Case Rate,
he/she is directed to Malasakit Center for assessment.
iii. Collecting/Cashier – collects the due fees indicated in the SOA.
 Note: Patient classified as “private” (or who availed the service of a private
physician) shall pay the hospital bills as indicated in the SOA. Further, he/she
shall settle the stated professional fee/s of his/her attending physician/s. NBB
patient has none to pay.

i. The patient’s Discharge Clearance Form (with attached operative record, as necessary) and the
SOA is fetched by a nurse station unit personnel (NOD / NAOD / IW / IT).

j. The patient’s companion or representative is directed to go to the Cashier for payment and/or for
initialing depending on the patient’s classification (private or NBB).

k. The completed Discharge Clearance Form is given to NOD / NAOD, who hands the written Home
Instruction Form and comprehensively explains to the patient and / or patient’s companion or
representative its content.
 Note: A written request for any laboratory and ancillary procedures as outpatient shall be
provided as an attachment if it is indicated in the discharge orders of the physician.
 Note: A written Referral Form to other services shall be provided if it is indicated in the
discharge orders of the physician.

l. The NOD/NAOD collects the filled-up Client Satisfaction Survey Form.

Prepared by Reviewed by Approved by

Miriam V. Ribac, RN

Marissa M. Mamate, MD Marissa M. Mamate, MD MARGARET JEAN DE GUZMAN, MD, FPSFP

OIC Chief of Hospital III
 Document
: QPMC-GL-MS-001
No.
DISCHARGE OF PATIENT Revision
Level
: 0

GUIDELINES Effective
Date
:
Page 4 of 4 Page :

m. The patient is accompanied or wheeled to the designated exit area.

n. The security guard – on – duty collects the clearance form and cuts the wrist tags of the patient
and his/her companion.

VII. Form
a) Clinical Cover Sheet Rev 2
b) Discharge Clearance Form
c) Home Instruction Form
d) Client Satisfaction Survey
e) Operative Record

VIII. Performance Indicator

a) All patients for discharge are appropriately provided with ICD 10 code based on the
diagnosis
b) All patients with surgical procedures performed have complete Operative Record prior to
discharge
c) All patients for discharge are properly verified as to category

Prepared by Reviewed by Approved by

Miriam V. Ribac, RN

Marissa M. Mamate, MD Marissa M. Mamate, MD MARGARET JEAN DE GUZMAN, MD, FPSFP

OIC Chief of Hospital III