Date
of Last Review: 6/4/07
SME: Director of Social Services
If an adult patient refuses to leave the hospital upon being discharged by the attending physician, the treatment team and appropriate supervisory and administrative personnel work together with the patient to ensure adequate discharge arrangements and a timely discharge. The patient is not to be escorted from the facility against his/her will by unit staff members.
Step |
Action |
1 |
The Social Service Clinician (SSC) reports to his/her supervisor and to the other members of the treatment team all patients who are at high risk of refusing discharge. |
2 |
The SSC and immediate supervisor work with the physician and the treatment team to establish a discharge plan that meets patient’s clinical needs and considers available resources. |
3 |
The treatment team explores patient’s preferences for discharge options throughout the treatment program and attempts to meet the patient's preferences when clinically appropriate and administratively possible. |
When an involuntary patient refuses to leave despite a court order to be released, the patient may be given the option to sign in voluntarily if the attending physician determines that the patient meets criteria for inpatient admission. Otherwise the SSC notifies the Director of Social Services who calls security to escort patient from the building.
When any other patient in all other circumstances refuses to leave at the time of discharge, staff does the following:
Step |
Action |
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1 |
Nursing staff notifies the physician, Nurse Manager, and SSC immediately. [Note: If the refusal occurs after hours (1700 hrs), staff returns the patient to the unit until the matter can be addressed the next business day. Nursing staff contacts the physician on-call to have the discharge order rescinded.] |
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2 |
The SSC
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3 |
If all staff at the case conference concur with the discharge plan as offered or revised and patient continues to refuse to leave, the SSC notifies the following to make them aware of the situation:
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4 |
The Director of Social Services calls security to escort the patient from the building.
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The Joint Commission : Provision of Care
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