Nervecentre V9.0 Help for Users

About the discharge process

This article explains the discharge process for our standard product. The discharge process you follow depends on your organisation.

Before you can discharge an inpatient, you must complete a discharge summary and TTO To Take Out. Each medication added to the discharge letter can be called a TTO. Also, the list of medications on the discharge letter can be called the TTO. list. You can complete these independently of each other, or at the same time.

All discharge summary actions must be done on a desktop. The TTO list must be started on a desktop.

Read about the discharge summary

Read about the TTO list

If you are placing a patient on home leave, you follow a similar process. You complete a home leave form and TTO list.

Read more about home leave

Overview of the discharge workflow

This is the workflow for our standard product, which includes a discharge summary you complete in Nervecentre. Your organisation might not have a discharge summary form to complete in Nervecentre.

You can do then , then , or and in parallel. When the discharge summary and TTO list are complete, move to .

	A doctor creates a discharge summary from Case Notes. They complete fields on the form, for example, adding a diagnosis, and notes for the patient's GP. Some fields are automatically populated from other parts of Nervecentre. The doctor checks the information is correct, and signs to confirm. Read about creating discharge summaries You can cancel the discharge summary at any stage. The TTO list remains populated.
	A prescriber creates the TTO list on a desktop. They can add current prescriptions to the TTO list, or create an empty TTO list. They can edit the TTO prescriptions, and add additional information, for example, prescription duration or GP actions. Read about creating a TTO list Read about editing TTO medications Read about deleting TTO medications You can complete the discharge summary and TTO list independently of each other, or at the same time.
	When the discharge summary and TTO list are complete, a clinician needs to check the TTO list. If the TTO list is blank, they select Approve, ward supplied TTO from the discharge summary.
	If the TTO list contains a list of medications, they need to decide if the ward can supply the medications, or if the pharmacy needs to dispense the medications. If the ward can supply the TTO medications, they select Approve, ward supplied TTO from the discharge summary. If the pharmacy is dispensing the TTO medications, they select Send to Pharmacy from the discharge summary. Read about the discharge summary From this stage, clinicians can recall the TTO list if it has changed.
	A pharmacist checks the discharge summary and the TTO list. They might add additional information, for example, source of supply, or quantity. If they don't approve the prescriptions on the TTO list, they select Pharmacy rejected from the discharge summary. Read about the pharmacy review of TTO prescriptions
	If the pharmacist approves the prescriptions on the TTO list, they can record who is dispensing the medications. If the pharmacy dispensary is dispensing the TTO medications, they select Approved, dispense in pharmacy from the discharge summary. If another pharmacy location is dispensing the TTO medications, they select Approve, dispense other from the discharge summary. For example, a satellite pharmacy. Read about the pharmacy review of TTO prescriptions
	A pharmacist in the pharmacy dispensary, or another pharmacy location, dispenses the TTO medications. When they have finished dispensing the TTO medications, they select Confirm dispensed from the discharge summary. They send the medications to the appropriate ward. Read about the pharmacy review of TTO prescriptions
	Two nurses on the ward check the TTO medications they received and the TTO list. If the TTO list has changed, they select Recall, TTO changed from the discharge summary.
	If the TTO medications have arrived at the ward, and they are correct, a nurse selects Confirm ward received and verified from the discharge summary. If the TTO medications are not correct, the nurse follows their organisation's policies to receive the correct TTO medications. Read about confirming TTO medications are correct
	A member of staff checks the discharge letter is complete, and ready to send. To generate and send the discharge letter to the patient's GP, they select Complete, send discharge letter from the discharge summary. Read about sending a discharge letter