When to discharge in Outpatient? (Full Version)

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cowboybuboy -> When to discharge in Outpatient? (July 18, 2006 8:04:00 AM)

I'm pretty new in outpatient setting and I apologize for the dumb questions that will follow. Just wanted to know when do we discharge patients from outpatient?
Is "maximum potential reached" enough reason to discharge a patient? If a patient is not improving for 1 month, or at least doesn't have significant improvement in 1 month, is it reason to discharge? If pain keeps coming back and you think physical therapy is not helping, is it reason for discharge?
Thanks to all!



Sean Weatherston -> Re: When to discharge in Outpatient? (July 18, 2006 8:56:00 AM)

I don't think it's a dumb question at all, I remember asking myself and others the same thing when I began as well.

I think that for the most part, I have found that you and the patient will come to an agreement when the time is right. Different patients have different goals, expectations, desires, motivation, insurance concerns, etc. so I personally think it's hard to have concrete standards across the board of when to d/c. I think the scenarios you mentioned are perfectly appropriate for the right patient.

My biggest challenge with discharging patients is those who want to come forever--sometimes I've had to hint a month in advance that the time to hit the road is coming up, LOL.



FLAOrthoPT -> Re: When to discharge in Outpatient? (July 18, 2006 12:50:00 PM)

if patient does not have some progress in 4 visits, it is time for referral back to physician, if symptoms worsen with each treatment for 3 or 4 times it worth referring back.. if patient plateaus and PT is no longer "skilled" it is time to DC, if patient is non compliant for a myriad of reasons, if patient is independent in the cognitive AND behavioral domains regarding their dysfunction and self treatment you can discharge, if PT becomes maintenance and pt can be trained in HEP, or untrainable, reason enough to DC....

now, just b/c they DC from skilled PT does not mean you cannot keep them coming to clinic on a cash paying basis.

Ben



SJBird55 -> Re: When to discharge in Outpatient? (July 18, 2006 1:18:00 PM)

For humor...
you discharge a patient when you no longer receive payment for services

you discharge a patient when you get sick and tired of seeing him/her

you discharge a patient when the paper chart is 1/2" thick

you discharge a patient when the patient has had 2 visits spending more than 3/4 the time discussing everything he/she knows about the supposed condition in which you are providing services

you discharge a patient when the patient expires



Sebastian Asselbergs -> Re: When to discharge in Outpatient? (July 19, 2006 1:53:00 AM)

SJ, SJ, SJ. You forgot to mention the discharge for "personal" reasons.....when they are cute....

It is funny how practice has changed in the clinic here. Discharge as soon as possible - not at 100%, but when patient has a good grasp of how to look after themselves. Makes them refer others, and even with the faster discharges, more referrals....
But, I am in direct access, private, cash-for-service practice, so patients can call whenever they need to come in for a review or re-test or whatever, so that makes it easier....



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