Elective Surgery Programme Implementation Support Guide

3. There are important implications for all clinical parties and for patients, their
representatives and carers in the expeditious and accurate production of discharge
documents.
4. After issue subsequent information may become available and this should be
delivered as quickly as possible.
5. The Discharge/Transfer Communication Record is a confidential document
containing personal information and is subject to data protection
6. This record should be communicated speedily to the patient‟s GP and Primary Care
Team as appropriate.
After discharge
There should be early notification of the patient‟s in-hospital journey to their general
practitioner using the Discharge/Transfer Communication Record by letter, Fax or
encrypted e-mail, approved by a senior member of the surgical team.
The record should be agreed with GPs to ensure medication changes and instructions
for care are clearly highlighted.
Clear arrangements should be formalized regarding liaison between hospitals, general
practitioners, public health nursing and patients/carers with regard to expected patient
recovery and outpatient follow-up or treatment where deemed appropriate by the
surgical team.
Unexpected readmissions should be direct and streamlined through an admission
process, avoiding the traditional emergency department route.
Indicators of Quality in Discharge Planning
Discharge planning is part of the elective surgical Integrated Care Plan at each stage of
the patient‟s journey
There is a dedicated Discharge Coordinator
All patients are provided with an estimated length of stay
There is a policy to discharge patients before 11.00 on the day of discharge
The discharge is nurse facilitated
All patients receive a uniform and agreed immediate Discharge Document forwarded to
primary care.
Discharge activity and patient experience is monitored through the Surgery Programme
Steering Group using appropriate metrics
94 Model of Care for Elective Surgery