IPD Discharge

Overview

Discharging an IPD patient involves three separate tools on the Patient Dashboard — none is a sequential step, and each can be used independently. All three are only visible when the patient has an active in-patient encounter.

When you mark the encounter as "finished," all allotted beds are automatically released (set to Unoccupied). This is handled by the encounter edit API — no separate bed release step is needed.

Encounter Edit (Marking Discharge)

This is where you close the encounter — setting the encounter status to "finished," recording the discharge disposition, and setting the discharge date.

Access

1. Patient Dashboard → Documents & Encounters → Search Edit Encounter.
2. Click the IPD No link for the encounter.
3. This opens /admin/patient/encounter/ipd/edit/?patientid={patientId}&encounterid={encounterId}.

The page uses the same encounter form as admission but in Discharge mode, pre-filled with existing encounter data. The API endpoint is /api/admin/ndhm/native/encounter/edit (editing, not creating).

Form Fields

The form shows all standard encounter fields (MLC, Status, Class, Date of Admission, Payor, Tariff Name, Policy Id, Department, Participants, Referral Doctor) plus two discharge-specific fields:

Setting the disposition automatically sets the end date to the current timestamp. If you select a disposition, the encounter status should also be set to "finished."

Why Finishing the Encounter Matters

Marking the encounter as "finished" is not just a formality — it has real operational consequences:

1. Billing isolation — If the encounter stays "in-progress," future bills could be wrongly posted to this encounter instead of a new one. A finished encounter prevents accidental cross-contamination of charges between admissions.
2. Bed count — In-progress encounters count against your organization's purchased bed limit. If unfinished encounters accumulate, the system will block new admissions with: "Your number of beds is X. In-progress admissions cannot exceed this limit. To admit new patients, please mark discharged encounters as finished or purchase additional bed count."

Discharge Check List

A structured care plan with pre-defined checklist items that nursing and billing staff complete before the patient leaves.

Access

Patient Dashboard → Documents & Encounters → Discharge Check List (/admin/patient/in-patient/discharge-check-list/{encounterId})

Checklist Items

The checklist has ~17 items organized into two groups. Each item starts as not-started and is updated to the appropriate status (e.g., "completed") by the staff member who completes it. The system records who updated each item.

Nursing tasks:

Billing tasks:

Print

Once saved, a Print DischargeCheckList link appears at the top of the form.

Discharge Summary

A FHIR Composition document that compiles the patient's clinical data from the admission and generates a structured discharge summary. This is a separate tool from the encounter edit and the checklist.

Access

Patient Dashboard → Documents & Encounters → Discharge Summary (/admin/doctor/records/bundle/discharge-summary-record/create?patientid={patientId}&encounterid={encounterId})

What It Includes

The discharge summary pulls data from multiple sources:

AI Generation

The discharge summary form includes an AI-assisted generation feature. The AI processes all documents tied to the current encounter — including lab results, medication records, procedures, conditions, and progress notes — and generates a structured draft discharge summary.

You can also provide additional input via a Dictaphone (voice-to-text) button. Use this to dictate special instructions, clinical notes, or any free-text comments that should appear in the final summary. The AI incorporates this dictated input alongside the encounter documents.

The result is a draft that covers the admission course, investigations, treatment given, condition at discharge, and follow-up plan — all generated from the actual encounter data plus your voiced instructions.

Edit and Print

Saved discharge summaries can be edited from /admin/doctor/records/bundle/discharge-summary-record/edit/{recordId}. The print URL is /api/pdfs/bundle/{compositionId}?bundletype=DischargeSummary.

Bed Release

When you set the encounter status to "finished," the edit API automatically releases all beds linked to the encounter — each bed's operational status is set to Unoccupied and its location entry in the encounter is marked "completed" with an end timestamp.

If you need to release a bed without finishing the encounter (e.g., moving the patient out of a room), use the Release Bed button on the bed allotment page.

FAQ

Q: Do I need to complete all three steps (encounter edit, checklist, summary)? A: Each tool is independent. You can close the encounter (mark it "finished") without completing the checklist or summary. However, a complete discharge record includes all three.

Q: Can a discharge be reversed? A: Yes. Edit the encounter and change the status back to "in-progress." You may also need to re-allot the bed if it was released.

Q: What if the patient leaves against medical advice (LAMA)? A: Select the appropriate disposition from the discharge form (e.g., "Left against medical advice"). Note the circumstances in the discharge summary.

Q: Does the bed release automatically on discharge? A: Yes. When you mark the encounter as "finished," the system automatically releases all beds — sets them to Unoccupied and marks their location entries as "completed." You do not need to manually release beds from the allotment page.

Q: Is the discharge summary printable on letterhead? A: Yes. The letter pad header configured in organization settings is used for printed discharge summaries.

Q: How does billing fit into discharge? A: Billing is handled separately through the Billing module. There is no "Discharged But Dues Not Cleared" encounter status — the encounter status is purely clinical (finished, in-progress, etc.). Ensure billing is finalized before or shortly after closing the encounter. See Bill Transaction.