University Hospitals Bristol
Discharge Lounge Operational Policy
Working Draft – 8 May 2013
1. Introduction
The Discharge Lounge is located <location to be decided following meeting of Estates Group in mid-may 2013>.
It is available for use by all wards and departments in the Bristol Royal Infirmary, BHI and BHOC.
2. Operational hours
The unit is open from 08:00hrs-20:00hrs Monday to Friday. At weekends, the lounge will be open from 10.00hrs to 16.00hrs.
Staffing and skill mix to be agreed following review of other Trusts and modeling of cost by Carole Tookey
3. Purpose of the discharge lounge
It is expected that on the day of discharge patients will transfer to the Discharge Lounge from the ward beginning at 8am and that all patients will be transferred by 10am.
4. Patients suitable for the discharge lounge
It is expected that on the day of discharge patients will transfer to the
Discharge from the ward should not be delayed because of patients waiting
Facilities that are available in the discharge lounge are: <Big it up>
· For transport to be booked
· For District Nurses to be booked
· TTAs to be dispensed (however, TTAs must be written by doctors and sent to pharmacy in advance of the patient arriving in the discharge lounge)
· Simple dressings
· Meals and drinks
· Administration of IV drugs and controlled drugs
These can all be arranged by the trained nurses in the Discharge Lounge.
5. Patients who are not suitable for the discharge lounge include:
· Infectious patients
· Confused patients and those with dementia
· Patients with complex mental health needs
· Unstable patients awaiting transfer to another hospital
· Bariatric patients – please discuss with discharge lounge staff
· Patients who require more than one person to assist with mobility
6. Discharge lounge facilities
· The Discharge Lounge has a large seated area with 8 reclining chairs and 12 chairs with pressure relieving facilities.
· There are separate male and female toilets available
· The lounge has access to a kitchen: light snacks, hot meals and hot and cold drinks are available
· Two cordless phones and free phone for taxi
· Television
· Hand washing sink
· Oxygen and suction will be available from a portable machine
· Crash trolley
· Controlled Drugs cabinet
· Notes trolley
· Two PC and desk with access to Medway and printer
· Electronic whiteboard and/or Magnetic whiteboard 1200 x 1200
· ? Wheelchairs
7. Patient pathway – booking, transfer to lounge, departure from lounge
7.1. Booking in to the lounge
· Discharge lounge staff will contact wards the day before discharge to confirm patients with an EDD in Medway
· Aside from this, ward staff and the matron of the day (e.g. following the leadership in flow meeting) can book patients into the lounge both in advance and on the day of discharge by telephoning extension X or bleeping the Discharge Lounge Nurse. If one phone line is busy then it will hunt for the other line.
· The discharge lounge staff will provide an update to the site office every day at 10.30am of their capacity. Should the discharge lounge not be at capacity, the site office will identify additional patients for transfer.
7.2. Transferring the patient to the lounge
· The Discharge Lounge staff will use the Patient Internal Transfer Handover Sheet (Transfer Policy Guidance 2012) for all bookings to ensure patient safety. <Confirm that the handover sheet references the need to ensure that drugs move with the patients>
· Patients will make their way to the lounge either on-foot or will be supervised by the discharge lounge staff (this includes the volunteers and nurse auxiliaries). ?Mobility assessment.
· The ward must not discharge the patient on Medway but instead transfer them to Discharge Lounge (the Discharge Lounge staff will ultimately discharge the patient once they have left)
· The discharge lounge will notify pharmacy department when a patient who is awaiting dispensing of TTAs arrives in the discharge lounge.
· Further discussion needed on transfer of0 patients awaiting INRs / Echos>
7.3. Care in the lounge
· Patients will have access to tea, coffee and cold drinks in the discharge lounge.
· For patients there for lunch and dinner, this will also be provided.
· The discharge lounge staff will complete the discharge checklist, including processing the patient’s TTAs which will be picked up for pharmacy on an hourly basis by the nurse-auxiliaries. The qualified nurse will explain TTAs to the patient.
· Bookings for transport and district nurses can be made by the discharge lounge staff.
7.4. Departure from the lounge
· The discharge lounge team will discharge the patient on Medway and ensure that the patient’s notes are ready for filing.
8. Staffing and line management of the discharge lounge
The line management of the Discharge Lounge is the responsibility of the Clinical Site Management Team and the day to day organization of the lounge is the responsibility of the duty trained nurse.
9. Infection control
· The infection status of all patients will be checked at the booking stage.
· Should any patient in the Discharge Lounge experience unexpected diarrhoea and/or vomiting the Clinical Site Manager bleep 2001 must be informed immediately.
· The Clinical Site Manager will decide on the appropriate course of action to support the continued discharge of the patient.
· If the patient cannot go home the CSM will arrange readmission to a cubicle.
· If the patient is still able to go home the CSM will arrange a cubicle for the patient to wait in.
· The Discharge Lounge must be deep cleaned prior to further use. Other users must be advised of the infection risk.
· Discharge Lounge staff will remind ward staff to remove Venflons prior to the patient leaving the ward but a final check will be carried out in the department.
10. Health and safety – Seb to advise
· The Discharge Lounge staff are responsible for reporting any problems with the fire alarms inc. low batteries
· The Discharge Lounge staff are responsible for ensuring all electrical appliances are unplugged at the end of each working day and the computer is switched off.
· The Discharge Lounge staff are responsible for flushing the taps and maintaining records in accordance with the Tap Flushing guidance
11. Contingency arrangements for staff shortages
Temporary staffing will be arranged to cover all planned vacancies. In the event of unplanned vacancies or if temporary staff are unavailable to cover planned vacancies the Clinical Site Manager holding bleep 2441 will be responsible in finding cover from other areas. If no staff are available then the lounge will close and the wards will be notified.
Discharge Lounge Operational Policy updated May 2013 Page 3