What Is an Unsafe Discharge From Hospital Facilities? 5 Red Flags

When a patient is discharged, this usually means they’re medically cleared for the next phase of their treatment plan — either continued at home or another health center. But sometimes, important steps of the care process are missed, and patients are discharged too early. But what is an unsafe discharge from hospital facilities and how is it defined?

Releasing a patient before they’re ready or prepared to leave is considered medical malpractice and can have consequences for all involved parties. To help you prevent this at your facility, we’ll walk you through what unsafe discharge is, why it happens, and red flags to look for in each of the care steps leading up to discharge.

What Is an Unsafe Discharge From Hospital? Definition

Unsafe discharge — also known as premature discharge — refers to when a patient is released from a hospital too early or without proper onward care arrangements. This can lead to complications during recovery, can negatively impact health, and may also increase the chances of a preventable readmission.

What Is Considered an Unsafe Discharge From Hospital Care?

Many different scenarios could be considered unsafe discharges. The most common instances of premature release from a hospital include patients being sent home:

• Before getting a proper diagnosis
• Without being medically stable
• Without a follow-up care plan

Why Do Unsafe Discharges Occur?

Unsafe discharges can occur both intentionally and unintentionally. Sometimes, patients are prematurely released because providers are worried that an insurance plan won’t cover expenses. In other cases, there may be a lack of understanding about a patient’s condition or miscommunication within the healthcare team.

What Are the Legal Consequences of an Unsafe Discharge?

Regardless of the reason, it’s crucial to avoid discharging patients into unsafe conditions, as this could be considered medical malpractice. Under federal and state laws and regulations on hospital discharges, healthcare providers have a legal duty to care for patients until they’re medically stable. Facilities that fail to enforce proper discharge protocols can be sued by patients for negligence.

What Are the Criteria for Safe Discharge From Hospital Care?

To avoid unsafe discharge, it’s important for facilities to have comprehensive discharge protocols in place. While policies can differ from hospital to hospital, experts typically recommend incorporating these key criteria for safe discharge:

• Effective communication with all individuals involved with the patient’s care
• Initiation of post-discharge health services to ensure continuity of care
• Implementation of social services and resources to support care transfer
• Patient education about discharge and at-home care management
• Early identification of a discharge date agreed upon by the care team
• An organizational review and audit of discharge by unit leaders
• Proactive discharge goal planning that starts upon a patient’s admission

What Is an Unsafe Discharge From Hospital Care? 5 Red Flags to Look For

Each member of the healthcare team can play a role in protecting patients against unsafe discharge. Watch out for these red flags indicating that a potentially inappropriate discharge order has been placed.

1. Unstable Symptoms

One of the biggest red flags is a discharge order placed for a patient who is not medically stable. If a patient is showing unexplainable or worsening symptoms at discharge, they should be thoroughly reevaluated before they leave the hospital. A patient with unstable vital signs could be in danger if they’re sent home without proper medical supervision.

2. Patient Confusion About Discharge Instructions

A patient being discharged should be well-equipped and educated to manage their condition at home. If a patient is about to leave the hospital but their discharge education hasn’t been conducted or documented by anyone on the healthcare team, this could indicate a misstep in the care process.

Additionally, some patients may not be mentally capable of caring for themselves or making the decision to go home. This is especially common when discharging elderly patients from hospital facilities. If a patient seems confused, or there are disagreements among the healthcare team about a patient’s mental capabilities, this must be resolved before they’re sent home.

3. Family Members Are Left in the Dark

In addition to the patient, all family members involved in care management should be notified and educated prior to discharge. A patient who relies on caregivers could be placed in unsafe conditions if they go home to a family that isn’t equipped to provide care. If you’re getting ready to discharge a patient and their family is confused or concerned, this likely indicates that there’s been some miscommunication during the discharge process.

4. Test Results Haven’t Been Given to Patient

If a patient is being discharged but some of their test results are still pending, this is also a red flag. Even if the patient appears medically stable, it’s important to get full medical clearance and wait for all relevant diagnostic testing results. Otherwise, you may be sending a patient home with an underlying condition that later manifests in harmful ways.

5. Lack of Coordination in Follow-Up Services

If a patient is being discharged to a different health center, it’s important to ensure that care has been fully coordinated. If no one on the healthcare or social service team is able to confirm how or where the patient is going to be transferred, this is a red flag.

Any post-discharge care arrangements should be initiated 48 hours prior to discharge. This ensures the patient has an appropriate place to go after leaving the hospital.

Does Your Facility Support a Culture of Safety?

Now that you know the answer to the question, What is an unsafe discharge from hospital care? you may want even more ideas on how best to protect patients. Need practical tips? IntelyCare’s newsletter brings you dozens of free nursing management tips and explainers to help you protect your culture of safety every day.