Inpatient EHR Clinical Discharge - hmislk/hmis GitHub Wiki

Inpatient EHR — Clinical Discharge

Page: /inward/inward_clinical_discharge.xhtml Reached from: Inpatient Dashboard → Clinical Data → Clinical Discharge. Privilege: InpatientClinicalDischarge — added in PR #19658 / issue #19677. Controller: InpatientClinicalDataController

This page records the consultant's clinical sign-off that the patient is medically fit for discharge. It is independent from the financial / room discharge — the patient may be clinically discharged in the morning and physically leave the room in the afternoon after the final bill is settled.

Why a separate clinical discharge?

Hospitals have three different discharge events that often happen at different times:

  1. Clinical discharge — the consultant says "the patient may go home". Recorded here.
  2. Room discharge — the patient physically leaves the bed and the room is released. Recorded on Room Discharge.
  3. Financial discharge — final bill is generated and paid. Recorded on Final Bill Generation.

Keeping them separate lets the consultant document fitness-to-discharge early in the day without waiting for billing / pharmacy.

What you record

Discharge details panel

  • Discharge Condition — autocomplete against the configurable list of conditions. Examples: "Stable", "Improved", "Transferred Out", "Discharged Against Medical Advice", "Deceased". The list is maintained in admin — see Admin — Inpatient EHR Discharge Conditions.
  • Discharge Date / Time — date and time of clinical fitness. Defaults to now; can be backdated.

Once the clinical discharge is confirmed (see below), both fields become read-only.

Discharge diagnoses panel

Add the final list of diagnoses the patient is being discharged with. The autocomplete is against the diagnosis vocabulary (diagnosisController.completeDiagnosis).

  • Pick a diagnosis → press Add → it appears in the table below.
  • Each row shows the diagnosis name plus a details/comment column.
  • An × link on each row removes it (only while not yet confirmed).

The diagnoses you add here drive the diagnosis card and discharge summary print (see Discharge Summary and Diagnosis Card).

Discharge summary panel

  • Discharge Summary / Clinical Notes — a multi-line free-text area. Typical contents: course in hospital, key investigations, treatments given, follow-up plan, advice. Up to several paragraphs.

Discharge medications

Captured on a separate page — see Discharge Medications.

Confirming the clinical discharge

When the form is complete, the consultant presses Confirm Clinical Discharge (or the equivalent save-and-confirm action). Effects:

  • admission.clinicallyDischarged becomes true.
  • admission.clinicalDischargedBy is set to the current user.
  • admission.clinicalDischargeDateTime is set.
  • A green confirmation banner appears at the top of the page: "Clinically discharged by Dr X on dd/MMM/yyyy hh:mm".
  • All the form fields become read-only — the discharge condition, diagnoses, summary, and date/time can no longer be edited.

To correct a mistakenly confirmed clinical discharge, the consultant can undo / un-confirm the record (where permitted by privilege). The room discharge and final bill flow are not affected by this state — clinical discharge is purely a documentary event.

What this page does not do

  • It does not release the room. Use Room Discharge for that.
  • It does not generate the final bill. Use Final Bill Generation.
  • It does not block further charges from being added — the BHT remains open until the financial flow closes it.

See also