Discharge a patient

At the early registrar level it is expected that a prevocational doctor will have acquired the skills, knowledge and behaviours to competently discharge a patient.

This task describes a number of activities, as below, where proficiency should be achievable by the end of PGY3.  The doctor is encouraged to download the key clinical task guidelines and seek the support of his/her supervisor for feedback on performance.

  • Exhibits a patient-centred approach to care
  • The medical aspects of aftercare are well sorted
  • Follow-up is planned (may not always be with the hospital)
  • Family and GP are informed
  • Delegates tasks to junior members where appropriate
  • Documentation is clear and informative
  • PGY 1
  • PGY 2
  • PGY 3
  • Communication
    • Use electronic resources in patient care, e.g. to obtain results, populate discharge summaries, access medicines information and maintain health records
    • Prepare discharge summaries and include current list of medication and reasons for any medication changes
  • Health advocacy
    • Is courteous and compassionate to all patients, without discrimination, regardless of a patient’s chosen lifestyle, e.g. discuss options, offer choices
    • Consider, and allow for, the impact of social, economic and political factors, as well as culture, ethnicity, sexuality, disability and spirituality, on patient illness and health
    • Able to advise on, or help to arrange, ambulatory and community care services appropriate for each patient

  • Judgement and clinical decision making

    • Synthesise clinical information to generate a graded problem list, containing appropriate provisional diagnoses as part of the clinical reasoning process
  • Leadership and management
    • Take responsibility for any task delegated
  • Medical expertise
  • Professionalism
    • Demonstrate empathy, caring and compassion for patients, their families and carers and treat them with dignity and respect

  • Collaboration and teamwork

    • Participate in shared decision-making activity involving patients, families and relevant health professionals, such as development of a care plan noting reference to open disclosure in ‘Communication’ section
  • Communication
    • Keep patients and significant others informed of management plan progress
    • Communicate effectively with administrative bodies and support organisations
    • Demonstrate high-quality written skills to communicate clinical actions, e.g. discharge summaries and completion of tasks before discharge
  • Health advocacy
    • Identify key issues on which to advocate for the patient to ensure their immediate clinical care and requirements are achieved
    • Recognise health needs of an individual patient beyond their immediate condition
  • Leadership and management
    • Delegate appropriate tasks to junior members, ensuring supervision is maintained
    • Able to discuss the structure and function of healthcare systems applicable to specialty and country
  • Medical expertise
    • Identify common risks in older and complex patients, e.g. falls risk and cognitive decline. Take appropriate actions to prevent or minimise harm
  • Scholarship and teaching
    • Provide constructive, timely and specific feedback to interns based on observation of a junior’s performance, encouraging them to reflect on their own learning

  • Collaboration and teamwork

    • Able to coach or supervise juniors, as required by the clinical task
  • Communication
    • Set an appropriate tone for any communication with patients and their families, peers and colleagues
  • Health advocacy
    • Adapt communication strategy according to the culture, values and beliefs of each patient
    • Work with the patient/family/carers to develop a management plan that addresses the needs and preferences of the patient
  • Leadership and management
    • Delegate appropriate tasks to junior members, ensuring supervision is maintained
    • Able to discuss the structure and function of healthcare systems applicable to specialty and country
  • Medical expertise
    • Provide appropriate aftercare and arrange follow-up for all procedures
    • Identify patients suitable for, and refer to, aged care, rehabilitation or palliative care programs
  • Scholarship and teaching
    • Provide constructive, timely and specific feedback to interns based on observation of a junior’s performance, encouraging them to reflect on their own learning