Complete the Patient Care Referral Form

 

The Patient Care Referral form and Certification can be completed by an MD, PA, NP, RN, or medical student. If completed by an RN or medical student, it must be cosigned. For additional information, see the Overview of Discharge Orders, Instructions, and the Patient Care Referral Form.

Required information is flagged with a red asterisk *

To help clinicians recall what will be seen by the patient, each field with information entered that prints on the Post-Hospital Patient Care Plan (PHPCP) is flagged with the icon. Please keep in mind that information on the PHPCP should be patient-friendly, phrased to be easily understood by people who don't have medical training.

Face Sheet Discharge Orders and Instructions are not available in the newborn nurseries. You cannot access the forms, even if you select a patient from the associated maternity unit lists or from patient lookup.

  1. Select the patient

  2. Click Face Sheet Discharge (ALT+F) or Discharge (ALT+G).

  1. Click the Pt. Demographics folder and review its information.

  2. Type additional information and comments as needed. To work in a larger text area, click the field, then click Zoom. To return to the order, click OK.

  1. Click the Certification folder to access this form.

  2. The default date of the patient's most recent physical examination is today—change the date if needed.

  3. As needed, click Yes or No to answer all of the questions regarding awareness of the patient's diagnosis, and whether you will follow the patient after discharge.

  4. If others will follow the patient after discharge, type a name, location, and telephone number for each provider. Click the up or down arrow on the scroll bar to the right of this section to access fields for more than one other provider.

  5. Click Yes or No to indicate if services are needed.

  6. Click to select one of the options to indicate the need for intermittent or continuous care that prompted this referral.

  1. Click Save.

  2. Type your signing key in the field provided.

  3. Click Yes or No to indicate whether the patient is ready to be discharged. If Yes, click one or more checkboxes to sign off on the discharge.

  4. Click OK (ALT+O).