VEEKU HOSPITALS

11 19, Cowley Brown Road, R.S. Puram, Coimbatore - 641002. Tamilnadu.

Ph : 0422 - 4971, 0422 - 4957967, Mobile : 8098880777, Veeku Lab : 8807127553, E-mail :veekuhospital@gmail.com

1. Purpose
To guide the healthcare team in evaluation, individualization and follow-up of a patient’s
discharge-related needs during and after admission.

2. Policy
Discharge process is planned in consultation with the patient and/or with family members in co-
ordination with various departments

3. Scope
All patients who are admitted at the hospital

4. Definitions
4.1.Discharge: Discharge from the hospital is the point at which the patient leaves the hospital
and either returns home or is transferred to another facility such as one for rehabilitation or to a
nursing home. Discharge involves the medical instructions that the patient will need to fully
recover.

4.2.Discharge Planning: A process used to decide what a patient needs for a smooth move from
one level of care to another.

5. Responsibility
Consultants, Staff Nurse and Executive

6. Process Details
6.1 Description of the Process
6.1.1. Discharge planning is to be initiated on the basis of the patients’ condition by the treating
team
6.1.2. Assessment of the patient is to be made for being ‘medically stable’ and fit for discharge.
This may include assessment of functional, medical, medication, and nutritional needs.
6.1.3. Discharge planning is a multidisciplinary, collaborative process involving the patient,
patient’s family, and concerned team members during a specific episode of illness.
6.1.4. Discharge planning involves several activities:
6.1.4.1. Evaluation of the patient by qualified personnel
6.1.4.2. Discussion with the patient or his representative
6.1.4.3. Planning for homecoming or transfer to another care facility
6.1.4.4. Determining if caregiver training or other support is needed
6.1.4.5. Referrals to other Consultants if necessary
6.1.4.6. Arranging for follow-up appointments or tests.
 VEEKU HOSPITALS
11 19, Cowley Brown Road, R.S. Puram, Coimbatore - 641002. Tamilnadu.
Ph : 0422 - 4971, 0422 - 4957967, Mobile : 8098880777, Veeku Lab : 8807127553, E-mail :veekuhospital@gmail.com

6.1.5. The Nurse in charge as well as the Registrars is responsible for coordinating the
discharge with other team members.
6.1.6. Routinely anticipated patient and family discharge needs are to be documented in the
Patient Discharge Summary.
6.1.7. The discharge summary will contain:
6.1.7.1. Details of the patient including Hospital IP Number
6.1.7.2. Date of admission and date of discharge
6.1.7.3. Name of the doctor in charge of the case
6.1.7.4. Patient history
6.1.7.5. Reason for admission.
6.1.7.6. Significant findings at admission
6.1.7.7. Diagnosis
6.1.7.8. Investigation results.
6.1.7.9. Details of any procedure performed.
6.1.7.10. Medications in the hospital
6.1.7.11. Other treatment given.
6.1.7.12. Course in the hospital and physical exam on duty of discharge
6.1.7.13. Follow up
6.1.7.13.1. Advice.
6.1.7.13.2. Medication.
6.1.8. Instructions regarding when and how to obtain urgent care.
6.1.8.1. Discharge summary will be provided to every patient at the time of discharge and
included in the case summary.
6.1.8.2. In case of a death the death summary shall also contain the cause of death and a
copy of the Death Certificate shall be kept in the Medical Record.
6.1.8.3. In case of discharge against medical advice (DAMA): Discharge summary shall
be given following the consent of the patient or patient relative.
6.1.8.4. For MLC cases ( NOT APPLICABLE )
6.1.8.5. Each Patient will be provided with a discharge summary on the day of discharge
and a copy of the Discharge Summary will be kept in the medical record.
6.1.8.6. Discharge note shall be duly signed by appropriate and qualified
personnel.(Consultant, Duty Medical Officer,)
6.1.8.7. The patient is instructed to come for follow up in the OPD.
 VEEKU HOSPITALS
11 19, Cowley Brown Road, R.S. Puram, Coimbatore - 641002. Tamilnadu.
Ph : 0422 - 4971, 0422 - 4957967, Mobile : 8098880777, Veeku Lab : 8807127553, E-mail :veekuhospital@gmail.com

6.2 PROCESS DETAILS

S. No Activity Responsibility
1 Development of a care plan for post discharge care Consultant
2 Arranging for the provision of services, including Nurse In charge
patient/family education and referrals.
3 The co-ordination related to discharge with other team Registrars / Nurse In
members charge
4 Preparation of Final discharge summary Registrars
5 Preparation of final bill Executive
7. Records and Formats
7.1.Discharge Summary Form

8. References: Nil
 VEEKU HOSPITALS
11 19, Cowley Brown Road, R.S. Puram, Coimbatore - 641002. Tamilnadu.
Ph : 0422 - 4971, 0422 - 4957967, Mobile : 8098880777, Veeku Lab : 8807127553, E-mail :veekuhospital@gmail.com

1. Purpose
1.1 To define the policies for patients leaving the hospital against medical advice OR what so
ever may be the reasons.

1.2 To have a mechanism for D.A.M.A / L.A.M.A patients

2. Policy
2.1 Patient has the right to leave hospital against medical advice.
2.2 Hospital has to follow the immediate following guidelines for D.A.M.A/ L.A.M.A

3. Scope
3.1.Patients admitted in the hospital.
3.2.Patients advised admission from either the emergency or OPD

4. Responsibility
Physicians, Nursing & Front office staff

5. Process Details
5.1 Description of the Process
5.1.1 Under the scope of patient rights, no patients can be kept in hospital against their will.
5.1.2 The nursing staff and the doctor concerned should try to persuade the patient to stay
and at the same time try to find out why the patient wishes to leave, if possible the problem
should be resolved.
5.1.3 It is the responsibility of the doctor to explain to the patient that if the patient leaves
the hospital against medical advice the hospital ceases its responsibility for his/her care.
5.1.4 Despite this if the patient still wishes to take his / her own discharge all possible steps
should be taken to ensure the patient/authorized attendant signs DAMA/ LAMA form to this
effect before leaving the hospital.
5.1.5 In the event that the patient refuses to sign the form, this should be documented
clearly in the Medical Records.
5.1.6 Patients are not allowed to leave the organization without information. In the event
that a patient does leave the organization without any information, a report shall be filed with
local police station. This shall be documented in the medical records and the Primary
Consultant shall be informed.
5.1.7 All discussions and risks explained should be recorded in the patient’s Medical
Records.
5.1.8 Discharge summary will be prepared and handed over to the patient.
5.1.9 Patient will be asked to clear all dues.
5.1.10 A copy of discharge summary will be kept in MRD department with the
patient’s/Relative’s signature and a witness’s signature along with name and contact number
5.1.11 In case of a patient leaving form Casualty/ OPD, documentation shall be done in the
refusal of treatment form
 VEEKU HOSPITALS
11 19, Cowley Brown Road, R.S. Puram, Coimbatore - 641002. Tamilnadu.
Ph : 0422 - 4971, 0422 - 4957967, Mobile : 8098880777, Veeku Lab : 8807127553, E-mail :veekuhospital@gmail.com

6.Activity and Responsibility

S. No Activity Responsibility
1 Development of a care plan for post discharge Treating consultant
care
2 Arranging for the provision of services, including Nurse Incharge
patient/family education and referrals.
3 The co-ordination related to discharge with other Doctor on duty/Nurse In
team members charge
4 Preparation of Final/Preliminary discharge Registrars
summary
5 Preparation of final bill IP Billing executive

7.Records and Formats

7.1. DAMA/LAMA Consent
7.2. Refusal of Treatment Form

8.References: Nil