Transcript CMHT Enquiry / Referral Pathway

Discharge Pathway
Admission into Hospital
For people with learning
Disabilities – begin discharge plan
Emergency Admission
Family/Carers to make contact with A&E To
inform of a persons needs
•Take the patient passport with you; ensure that up to
date medication is clearly identified within patient
passport/bring copy of medication/mar chart
Triage
•Ensure nurse is aware of the persons additional needs
and share or complete patient passport with carers
Waiting time
Planned Admission
Preparation for admission
•Hospital ward to make contact with the person as far in
advance as possible so that arrangements can be made
•Person is assessed by pre-admission services
•Discuss issues of consent; does the person have the
capacity to consent to this treatment; is it likely that a
best interests meeting will need to be arranged
•Identify if the person has a patient passport, if not
complete with the person or give carer details and suggest
to bring passport when person is to be admitted; are there any
Reasonable adjustments that need to be made
Arrange visit to ward [if required]
•This will help to reduce anxiety for both the person with a
learning disability and or family/carers and enable questions
to be asked prior to admission
•Try to identify a named contact for the carers if possible
•Consider contacting the CTLD/Health Facilitator/Acute
liaison nurse for support
•Extra support during admission; think if this will be likely
Admission to ward
•Consider if access to a quiet area may be of benefit to
the person to minimise distress for the person
•Share/complete patient passport with ward staff
•Ensure that up to date medication is clearly identified within
patient passport/bring copy of medication/mar chart
Fast-tracking through A&E
Complete Care Plan
•A person may be fast-tracked if deemed appropriate by
the admitting doctor/triage nurse
•The patient passport with assist in the development of the
persons care plan; this will ensure that the persons everyday
needs are addressed and met ie times of medication, eating
and drinking, pain management ; this will help to reduce
diagnostic overshadowing
Admission to the ward
•Share the patient passport with the ward
staff to ensure that they are aware of the
persons additional needs ie medication
/epilepsy/eating and drinking etc
Carer support
•Ward staff should discuss with carers/others to identify the
level of support needed to care for the person in hospital
•This may mean seeking extra support and funding will need
to be agreed by the Modern Matron
Discharge Planning Meeting
Consent to treatment
•Does the person have the capacity to
consent?
•Can the decision wait until the person
has the capacity
•If not, a best interests meeting must be
called by the decision maker
•Who is the decision maker; the doctor is
the decision maker with regards to
medical treatment
•Evidence of the decision must be
recorded on the decision record (DOH
form)
See decision making and best interest
pathways for further details
•Discharge Plan will begin at point of admission with an
estimation of date of discharge (EDD)
•As soon as discharge is considered, contact the people
who know the person best ie family/carers/professionals
involved with the person and the discharge planning team
•Ensure that all aspects of the persons care is discussed
and action plan agreed to meet the needs of the person at
discharge. This should be documented as part of the
discharge plan
•If a persons care needs have changed, ensure that a
section 2 is completed
•Ensure that all actions are completed /equipment needed
obtained prior to discharge
•Ensure Immediate discharge letter (IDL) is completed with
full details of current medications/health conditions is
completed. This IDL will be faxed to the GP at discharge
•Ensure that the person/family carer/professional carers are
aware of the medication changes or new medication
regime is clearly understood and checked at point of
discharge (This will contain either 14 or 28 days of
medication, enough medication until their next prescription
Pathway based upon Department of Health (2003) Discharge from Hospital; pathway, process and practice , London, Department of Health
Appendix 5.7 Guidelines for the acute sector when caring for someone with a learning disability –
Allyson Kent (2008)