Hospital Discharge Template: Fill & Download for Free

This is my personal case: I got tired of wasting time in useless tasks imposed by the Government and insurers.Each insurer have their own list of medications that they cover and the lists keep on changing. You write for a medication that the patient has taken for years but now the insurance has changed its medication list. I have to listen to the patient’s complaint and anger. The insurance faxes you a whole list of pages and you waste precious time answering questions to see if they will make an exception and approve the drug. Most of the time the answer is No and you have to write for something else and listen again to the patient’s complaints.You need to perform a procedure, you apply for approval and a third party approves the procedure and tells you: the procedure is approved but it does not mean it is a guarantee of payment. In what profession you do a job that is approved but you may end up not being paid because now the insurance thinks that it was not needed or there was something else that could have been done? That was very frequent with hospitalizations. I admitted a diabetic, hypertensive, smoker man in his early 60’s for chest pain. EKG in ER was normal. After a few hours his pain was on/off and I decided to transfer him to a different facility where he got a cardiac cath showing severe obstruction of his coronaries and ended up with 3 stents. The insurance denied payment to the first hospital and me because the EKG was “normal” and the admission “was not necessary”. My appeals using the results of the cardiac cath were useless and they kept on saying the EKG was “normal”. A normal EKG means just that, that it is normal. You can be in the middle of a heart attack and have a “normal” EKG. It is not uncommon that an EKG takes 4–6 hours to show damage from a heart attack. My patient was outraged at the situation and kept on calling the insurance on a daily basis to complaint to the Customer Service. After a few months I got paid not because of my appeals, but probably because they got tired of listening to the guy on a daily basis. And this case it is not one of my worse ones. The frustrating part is that the person that does the first step of approvals is not a physician. It is just a clerk sitting at a computer. If the computer says YES you are OK, but if it says NO then your Calvary starts.The Government wants electronic records because according to them they are more accurate. Well, that is BS. Many physicians use templates and their choices are limited. Many people to save time just “copy and paste”. Then you see the same note over and over. If the first person makes a mistake, then the mistake keeps on passing on and on. If you are a little fast with the mouse you may record the wrong data or choose the wrong template. I got CT scans of women with normal prostate. Some templates are politically correct. First they ask for sex and they offer: male, female, undecided, transgender male to female/transgender female to male. Then sexual orientation: heterosexual, homosexual/lesbian, bisexual, undecided, other (specify). “Other (specify)” are we talking about animals? Do we have to specify which one? The amount of information you have to input in the record is unbelievable and very time consuming. You may see a person in 15–20 minutes and expend 1/2 hour in the record. The choice you are given is to see patients and expend time with them and then fill the records after working hours at home ( I used to finish by 10:30 PM and I am a fairly fast typist) or cut patient time. Neither one is fair. The only advantage of electronic record is that they are legible. One problem is that you need Internet access. I worked in New York and when hurricane Sandy hit us there were no phones or internet access in my area for about a month. Luckily for me I had copy in paper of my medical records so the records were available to me.Excess of paper. In the past if you sent somebody for a consult you would get 1–2 pieces of paper. Now you get 8–10 with a lot of duplication in information that most of the time is useless. Hospital discharges used to be 2–3 pieces of paper, now the patient comes with a Hospital Discharge that it is no less than 10 pages or more. A few weeks before retiring I got a medical record of a patient’s hospitalization: 127 pages on the fax machine. Now you have to scan it, put it in the medical record and you are supposed to read it too.You have to be up to date and that takes time and money. I had to get a certification exam in my specialty every 7 years. Being a family physician it means to be up to date in internal medicine, surgery, pediatrics, gynecology and obstetrics, behavioral medicine and psychiatry. My practice was limited to internal medicine and pediatrics. But I had to read about the other specialties in order to take the exam. It is better to be a specialist. Al least you do not have to spend time studying things that you do not do.I went to Medical School to learn Medicine and take care of people, not to be an overburdened bureaucrat. So after 43 years in the medical field I decided I was not going to be what I did not want to be and I quit. Am I happy? Yes. I have time to share with my family and friends, to read the things that I like, to practice fencing that I love, to visit new places, etc. I am a person again. No regrets.

To be fair, there is no conspiracy behind our former CM Jayalalitha’s death. It was an unspoken truth that she was ‘very ill’ for quiet sometime. She had rheumatoid arthritis for 40 years and was on corticosteroids for a very long time (bdw that’s why she was overweight and diabetic- side effects of steroids), which was leading to severe renal and lung complications. During the peak of her political career her health was failing her very badly. In fact during the May 2016 election campaign she would get breathless at times. I was keeping my fingers crossed hoping that she would pull it off for at least for two more years, with treatment. But our God and fate had other plans. Given the graveness of her heath, the doctors, the hospital and the near ones did their best.But why this controversy now?Lack of transparency and ‘hush hush’ manner of the whole thing.She was not any other political leader or a movie star or a normal person, admitted in hospital. She was the people’s representative, our sitting CM. The privacy of the patient should be maintained. No doubt. But at least the gravity of the situation should have been conveyed to the people. Her ministers kept assuring that she was ‘completely alright’ and she was just resting and recovering, which was a false promise being given to the people.No one was allowed to visit. Right from Central ministers to state ministers to governor, everyone was denied access. Had some neutral person visited her, at least seen her from a distance, this whole controversy wouldn’t have blown up. Political leaders do fall sick and their privacy should indeed be maintained. But someone should have been allowed to visit, at least from a very good distance (to prevent infection) and reassure that the person is ‘alright’. A strict access to no one was raising a lot of eyebrows.The health bulletins released by Apollo hospital were ‘vague’. Considering that common people without any medical knowledge were reading the bulletins from the Apollo hospital, the whole situation could easily be misunderstood. Initially they quoted fever and dehydration, then they mentioned ‘infection’, then they mention assisted respiration, then it was Richard Beale, then it was our former CM recovering, then it was physiotherapy, then she was shifted to normal room, then it was discharge in 4 days, then it was cardiac arrest, followed by ECMO, situation grave, not responding to treatment and then the finale- sad demise. A clear diagnosis was not given at any point of time.The health bulletins released by Apollo reminded me of an activity in English comprehension called story outline. This is exactly what is happening - people have started building up their own story. They are connecting the first and the last dot- fever dehydration to death. According to a regular lay person, our former CM was admitted just for fever and dehydration and after 75 days she expired,. So they are asking, how can this happen in spite of the international treatment and facilities that was apparently available?After the demise of our CM, the people who were surrounding her mortal remains were very controversial figures. It is an open fact that she despised certain people and cut all ties with them, because she suspected that they were plotting something against her. After her demise all those people were surrounding her. Paying homage was different and standing there for the whole time was different. It didn’t take a long time for the common people to make a story outline from the template given by apollo.To add fuel to the fire, Apollo conducted a condolence meeting, where they gave press statements like these.All You Need Know About Jayalalitha Last Days in Apollo Hospital | Press News ReleaseLet’s go home, I will give you the best tea, Jayalalithaa told medical staff - Times of IndiaStatements like these irritated people. If CM was doing this ‘good’, giving beauty and hair style tips for the doctors and nurses, then why was she not allowed to meet anyone? If I am not wrong, it is believed that emergency tracheotomy was done for Jayalalitha when she was admitted and was on full sedation for a long time. In fact Dr.Prathab Reddy himself admitted that Jayalalithaa’s speech has ‘almost gone’ and she is learning to speak with the help of microphone and that she was being given physiotherapy for her chest, hands and legs (her hands were not functioning, that’s why few weeks back for an important emergency government order her thumb impression was given). I don’t know how she was able to grip the portable MP3 player and hear songs, nor have a tete-a-tete time with the nurses there. So we can infer that she was sick. In fact very sick. When people are just beginning to accept this fact, doctors and nurses giving out sweet memories, is irking them. People are just plain confused. They want just one statement from her government - her diagnosis. What went wrong with her? People voted for her, trusting only her, and not even single person other than her in the party. They feel angry, they feel they atleast have the right to know why she is no more.

You can, however you need to make sure that you have a plan for the baby’s care if you do so. This is more than just telling your nurse that’s what you plan to do. If you just leave, whether AMA or with a doctor’s discharge, without making a formal plan - meaning there is some paperwork signed, and the hospital knows who the baby will be discharged to, then they will call social services and you will be charged with abandonment.You have a couple of options.Option 1: You leave, they hotline you and social services takes the baby into temporary foster care while they follow their procedures which typically involve trying to contact you for a reunification plan of some kind, or, if that doesn’t work, placing the baby with a foster to adopt family on their list. Generally adoption in this scenario takes a year or more for the adoption to be finalized. This can affect you later on, with other children you may have, particularly if you are actually formally charged with abandoning a child.Option 2: You can ask if you are allowed to claim Safe Haven for your child. Most states have some sort of safe haven law that allow you to leave a child at a medical facility, or other emergency facility such as a police or fire station, with no further repurcussions to birth parent(s) in the future - such as may happen if you leave without claiming safe haven and they decide to call it abandonment. Again, you must tell a qualified professional (such as a nurse or the hospital social worker) and they must follow the state procedure - laws vary - to accept a safe haven baby. You cannot just leave without following the procedure or it will revert to option 1.Additionally, you need to make sure that whoever you report the safe haven to actually knows what they are doing. I have been called in situations where a mom was trying to claim safe haven for her baby, and the professionals had not been trained in local laws and basically treated it as an abandonment, which was exactly what birth mom was trying to avoid.If you do this the baby will be placed in temporary foster care by state social services and then placed for adoption through the state foster care system - often with the foster family.Option 3: Call a private infant adoption agency, such as the one I work for. The hospital social workers should be able to give you a list of local agencies, or if you have internet access search for one in your area, or close to it. If there aren’t any local agencies there are many who work nationwide (mine does.) In this scenario you have a number of things in your control that you do not in the other two options. First, and maybe most important to you, you can choose the adoptive family. The agency will have a list of families who are already homestudy approved (which is required for legal adoption) and show you profiles or websites so you can get an idea of what your child’s life would be like. You can make requests about the family, such as a particular religion, geographic location, or keeping in contact with them after placement.You will also likely meet with a social worker and/or attorney, which will help protect your rights and terminate them correctly per your state law. This means that you will not be charged with abandonment, unless you leave without signing any documents stating that adoption is your intention for this child. Most agencies or attorneys will have templates of these documents already that meet your state laws and make sure you are properly represented.Additionally, many of my clients are specifically looking to avoid foster care for their child. Although some private agencies do offer private foster care, sometimes called cradle care, you also have the option of the adoptive family coming to the hospital to care for the baby, and the baby being discharged to them directly, rather than risk the child being placed in state foster care. This avoids the baby being bounced around and starts the bonding and attaching process with his/her/their parents right away, which most will tell you is what is best for the child.Lastly, let me encourage you that by making a plan for your child, even if that plan does not include you raising the child yourself, you are being a good mom. If you are considering leaving the hospital without your child for any reason, I would suggest getting in touch with the hospital social worker there, and a local adoption agency if that option appeals to you. We do work with pregnant women to make an adoption plan and coordinate with the hospital, so there is no confusion about abandonment. We also will not pressure you one way or the other, just provide the information you need to make the decision that works for you and your baby.