ChELO (Discharge)

More information will be posted soon.

In brief, why would a discharge checklist be useful? Well, given that we have demonstrated a preponderance of ethical errors are made with regard to treatment in Ontario hospitals, it should be no surprise that similar errors are made with respect to the transition of patients from our hospitals to home, LTC, nursing homes, or other destinations. Further, discharge becomes complicated at times because responsibilities are shifted to different parties (e.g. CCAC responsible for proposal of LTC or personal assistance services in the home; discharge coordinator responsible for facilitating transition to home which does not require consent).  We believe a checklist can assist hospital staff in ensuring that patients’ rights are upheld, and where appropriate, that their best interests are fulfilled.

Update: The following table that outlines appropriate responses to common yet difficult discharge scenarios will appear in an upcoming paper to be published in Healthcare Quarterly

Acute Needs ALC Designation Capacity to Consent to LTC or Personal Assistance Services Consent to LTC or Personal Assistance Services Scenario Proposed Outcome
No N/A N/A N/A - Discharge
No ALC Capable Yes Waiting for bed Hospital charges Co-payment
No ALC  Capable Yes Refuses bed that has become available Discharge home or Hospital charges per diem
No ALC Capable No Patient wants to stay in hospital Work to improve patient to point of discharge
No ALC Incapable Yes (SDM) Waiting for bed Hospital charges Co-payment
No ALC Incapable Yes (SDM) SDM refuses bed that has become available Hospital charges per diem; CCAC files form G application with CCB
No ALC Incapable Yes (SDM) Consents to only one home with inappropriate wait list Hospital charges Co-payment; CCAC considers form G application with CCB
No ALC-home Incapable Yes (SDM) SDM refuses on day of discharge Hospital charges Co-payment
No ALC-home Incapable Yes (SDM) SDM withdraws consent prior to discharge CCAC files form G
No ALC Incapable No (SDM) SDM refuses to identify even one home CCAC files form G application with CCB