This paper presents the expectations of Orthopaedic Patients about the discharge procedure following their operation.

Many patients will not have a 'simple' discharge to their residence. There may be other factors, such as other medical conditions, that need to be taken into account in the discharge plan to enable a smooth return to their residence.

In order for there to be a smooth transition from admission through to discharge, the following steps should be followed:

1. The Discharge Plan should be considered part of the Hospital pre-admission process. The discharge plan will consider & include:

   1. My transfer, if necessary, from the Surgical Unit to the appropriate Orthogeriatric, Medical or Rehabilitation Unit in the hospital.

   2. The expected Date of Discharge.

   3. An assessment of expected needs, Community Health and Social Care.

   4. My Family/carer/friend (and possibly Residential Care Home Manager) so that they are kept informed of likely support and kept up-to-date with any changes to the Discharge Plan to ensure there will be someone at my residence.

   5. Arrangements with the appropriate Transport Service (if my Family/Carer cannot fetch me) so that they are kept informed of any changes to the schedule. Each should provide a contact telephone number to the other.

   6. Ensuring that I, or an appropriate family/carer/advocate, fully understand the whole process and where possible, have consented where possible.

   7. Having an assessment carried out to ensure continued necessary care in the community.

   8. That if I need temporary care in a Home my Family/Carer is given full support to identify the most appropriate place, & that the Home is fully briefed to receive me.

   9. That any changes in my expected discharge date are discussed with me and my family/carer/advocate, and that the Community Team is informed.

   10. Assurance that on discharge all prior arrangements will be fully carried out and my GP and Community Team have confirmed they have the necessary facilities prior to my return to my residence.

   11. Any 'take home' medicines, dressings, walking aids, orthotics, physiotherapy etc are planned for, sourced local to my residence when possible and provided in good time.  Resolving cross-boundary issues must be the responsibility of my care team.

   12. That all necessary equipment is delivered & installed prior to my arrival.

   13. I am allowed home on an agreed day and at an appropriate time, and that I am properly dressed in my own clothes, with all my personal belongings, so that my dignity and safety are maintained.

   14. If I am going to a Care Home the Manager is fully briefed with my discharge assessment, and in full agreement with my being sent into the Home's care.

2. Good discharge planning offers certain benefits to the care team which includes me as the patient:

   1. I will know what I need to do to help with my recovery.

   2. I am able to make plans with my relatives/carers/friends about my discharge.

   3. I understand what I need to do and can actively participate in my recovery.

   4. I might get home sooner and reduce the risk of hospital acquired infection.

   5. Adult Social Services and Community Health Care teams will know immediately of my discharge, if appropriate, and can support me.

   6. I am less likely to be readmitted.

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Guidance last reviewed June 2011