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Informed discharge

Alerting patients to warning symptoms and signs

What patients need to know

Caution sign
  • Symptoms and signs alerting them to seek further medical care.
  • Advice tailored to their specific clinical situation.
  • They are welcome (made to feel comfortable) to return for re-evaluation.

One Canadian court judgment stated that patient information should include not only instructions regarding appropriate care, necessary medication, frequency and nature of follow-up visits, but also instruction on the predictable complications and any symptoms or signs alerting to danger.

The information should be tailored to each patient and each clinical situation. This advice would include discussion of the potential side effects and monitoring requirements of any prescribed medications.

It is a fine balance between alarming patients and giving them a false sense of security.

Just as when obtaining informed consent, it is important to describe the symptoms and signs of even rare complications if the potential harm is serious. If the patient has any questions during the discussion, the questions should be answered. The discussion with the patient should be documented in the medical record.  

Female physician explaining content of a patient care handout to young female

Patient care handouts

  • Handouts support the informed discharge discussion but do not replace the personal interaction.

It can be very helpful to give the patient (or the person taking the patient home) written instructions. These are supplements to the personal interaction, but cannot replace it. Handouts may be fairly general. Any parts that don't apply to the particular patient or specific clinical situation should be deleted; if points relevant to this patient are absent, it might be helpful to add them.

Families and companions

  • Consider the safety of the "incapable patient" and provide appropriate advice to those who will be with the patient.

Patients may be discharged from an emergency department or a day-surgical facility while still not fully capable due to alcohol or drugs taken prior to arrival, or medications such as anaesthetics or sedatives that were provided while under medical care.

In these circumstances the patient should generally be accompanied by a relative or friend who is willing and able to help. With the patient's consent, that individual should be part of the discharge discussion.

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