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. Updated key clinical tasks will be available soon for download.

  • 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

Related Competencies:

Communication

Comply with organisational policies regarding comprehensive and accurate documentation
Communication

Use electronic resources in patient care, e.g. to obtain results, populate discharge summaries, access medicines information and maintain health records
Communication

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
Health advocacy

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
Health advocacy

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

Manage common conditions
Professionalism

Demonstrate empathy, caring and compassion for patients, their families and carers and treat them with dignity and respect
Scholarship and teaching

Reflect on and learn from own observations of clinical practice
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
Communication

Communicate effectively with administrative bodies and support organisations
Communication

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
Health advocacy

Recognise health needs of an individual patient beyond their immediate condition
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
Health advocacy

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
Leadership and management

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
Medical expertise

Identify patients suitable for, and refer to, aged care, rehabilitation or palliative care programs

The JDocs website is an initiative of the Royal Australasian College of Surgeons.

The aim is to provide career guidance to junior doctors in Australia and Aotearoa New Zealand during the early prevocational years.

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