Treatment Episodes: Discharge Workflow

The discharge process has been streamlined and clearly defines the transition from active treatment to discharge.

This workflow ensures accuracy, as the inability to change the discharge date and type outside the workflow ensures data integrity and prevents accidental or undesired data manipulation.

Required Permissions: Super Admin, users with the Allow Discharge/End Episode feature enabled in the user profile. Click here to learn more about user permissions.

You can initiate the discharge workflow through Manage Episode, or a discharge evaluation form using a discharge date field.

Discharge Workflow Video

Discharge Workflow using Manage 

To use the Manage Episode discharge workflow, follow the steps below.

1. Open the patient’s chart and click on Manage.
2. Alternatively, click on the arrow next to Manage and select Discharge.
3. In the pop-up window, select Discharge.
4. Assign the discharge date and discharge type.
5. If needed, click on the Discharge To field and begin typing the contact’s name. The system will show matching facilities from the Company Contacts list.
6. If not found, set the Create New Contact? toggle to on and free-type the contact’s name. The contact created this way will be added as a new contact under Company Contacts.
7. Click Save to complete.
8. The patient’s status changes to Completed.

Discharge Workflow using an Evaluation Form

You can also start the Discharge Workflow by using the facility discharge form with the patient.discharge_datetime or patient.discharge_type fields.

Note: Only one of these fields is required in the evaluation form as both perform the same function.

Follow the steps below: 

1. Super Admins or users with the Manage Templates feature can configure the facility discharge form under Templates Evaluations, ensuring the patient.discharge_datetime field or patient.discharge_type field has been added.
    
2. Once configured, the Discharge button will appear in the form.
3. Go to Step 3 above and complete the discharge workflow.

Discharge Workflow using the Facesheet

1. Open the patient’s chart and click on the Edit Client button.
2. Click the Discharge button in the patient’s facesheet.
3. Go to Step 3 above and complete the discharge workflow.

What Happens After Discharge? 

1. All activities stop in the patient’s chart (e.g., med log generation stops, future appointments are removed, the patient no longer appears in the current census, and the chart moves to the chart audit section). 
2. The system displays a green tile in the MR number field to indicate an discharged status.
3. All Treatment Episodes marked as In Progress change to Completed.
4. A Discharged event is added in the Episode of Care Summary, with all events listed in reverse chronological order.
5. Users can no longer edit a discharge type via evaluation form with patient.discharge_type. This field will be read-only in the form or facesheet moving forward.
6. After finishing the discharge workflow, the system updates the patient episode of care status from Active to Completed.
    
7. The discharged patients are listed in the Chart Audit section of Kipu EMR.

Note: If the completed chart is closed, it will be removed from the Chart Audit section.

Edit the Discharge Event

• Once the discharge workflow is complete, you can edit the Discharge Type by clicking on the pencil icon.
• Select the new Discharge Type from the drop-down list and click Update.
• The system display the updated Discharge type.
• Click on the Staff icon to read the staff member name and time stamp of the event.

Undo the Discharge

Use Undo when the entire event needs to be removed. Example: If you discharged a patient by mistake, the Discharge Episode should be removed entirely. Undo is only available when the discharge is the most recent event, and no documentation is attached to that episode. Click here to learn more about the Episode of Care Summary.

• Click on the undo icon next to the discharge date on the patient’s Facesheet to remove the event.

• Alternatively, open the Episode of Care Summary and click the Undo icon next to the Staff icon to remove the entire discharge event.

• Enter the reason for the undo and click Undo Event.

• The undo Discharge Episode will appear grayed out to indicate it has been modified.

• Click the Information (i) icon to view the staff member’s name and the reason of discharge. You can click on the Staff icon to see who discharged and the timestamp.

• To restore the Undo option, move all documentation out of the Discharge Episode using Move Records in Bulk from the Chart Summary>Treatment Episodes tab. Once the episode is documentation-free, Undo will reappear again.