Junior doctor survival kit
Planning a patient’s discharge
Planning can begin before the patient arrives
From your first day as a junior doctor you will be involved in planning an essential part of a patient’s journey—the discharge. Although medical school provides you with the skills to assess and start management, less focus is given to your role in safely discharging patients, and this important aspect of patient care is poorly managed.1 This article focuses on elderly patients.
Effective planning ensures that patients are discharged safely and at the right time. If done well it can benefit the patient’s health and the hospital’s finances. An unnecessarily prolonged stay can increase a patient’s risk of hospital acquired infections,2 such as Clostridium difficile and meticillin resistant Staphylococcus aureus, and may lead to loss of social networks, dependence, and even institutionalisation. Delayed discharges also lead to reduced availability of beds and cost the hospital more. Conversely, a discharge that is too early may leave a patient unable to manage