If you have an issue with this template then please raise an issue in Simplifier against this IG by using the 'Propose a Change' link in the footer
Discharge details
The Discharge details section carries details of the patient's discharge. PRSB Elements should be formatted as subheadings in any HTML sent.
| Section | Description | Card. | MRO* | FHIR Target and Guidance |
|---|---|---|---|---|
| Discharge details | The details of the patient's discharge from hospital. | R | Carried in the CodeableConcept of Composition.section.code FHIR element. ValueSet UKCoreCompositionSectionCode | |
| PRSB Element | Description | Card. | MRO* | FHIR Target and Guidance |
| Discharge status | Patient status on discharge from emergency care. | 1 only | M | This is sent as text and "MUST" be included in the FHIR element Encounter.extension(emergencyCareDischargeStatus) and will contain a code from the SNOMED Clinical Terminology UK coding system that describes the status of the Patient on discharge from an Emergency Care Department. Captures whether treatment took place within the ED, if the patient was streamed to another service or if the patient left before treatment was complete. Any code from the SNOMED CT UK 'Emergency care discharge status' subset with subset original id 75041000000135; the corresponding SNOMED CT UK Refset fully specified name is 'Emergency care discharge status simple reference set (foundation metadata concept)' with Refset Id 999003021000000104. |
| Date/time of discharge | The actual date of discharge | 1 only | M | Text indicating date and time of discharge as recorded by the PAS or discharging system. This SHOULD also be carried in the FHIR element Encounter.period.end. |
| Discharge destination | The destination of the patient on discharge. National codes. Eg, High Dependency Unit. | 1 only | M | Text and coded using a value from the ECDS Emergency Care Discharge Destination subset (SNOMED CT) with original subset ID of 75031000000130 which is carried in the CodeableConcept of the FHIR element Encounter.hospitalization.dischargeDisposition. |
| * M=Mandatory R=Required O=Optional | ||||
Example Discharge Details Section
{ "resourceType": "Composition", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Composition" ] }, "status": "final", "type": { "coding": [ { "system": "http://snomed.info/sct", "code": "373942005", "display": "Discharge summary" } ] }, "subject": { "reference": "urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9" }, "encounter": { "reference": "urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd" }, "date": "2023-01-28T10:00:00+00:00", "author": [ { "reference": "urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f" } ], "title": "Cardiology Service Discharge Summary", "section": [ { "title": "Discharge details", "code": { "coding": [ { "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings", "code": "discharge-details", "display": "Discharge details" } ] }, "text": { "status": "additional", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><th>Discharging consultant</th><td><p>Prefix: Dr</p><p>Given Name: Paul</p><p>Family Name: Rastall</p></td></tr><tr><th>Discharging specialty/department</th><td>Cardiology</td></tr><tr><th>Discharge location</th><td><p>Name: Cramer ward</p><p>Identifier: RR8CRAM</p></td></tr><tr><th>Date/time of discharge</th><td>29-Jan-2023 10:58</td></tr><tr><th>Discharge method</th><td>Patient discharged on clinical advice or with clinical consent</td></tr><tr><th>Discharge type</th><td>Usual place of residence unless listed below, for example, a private dwelling whether owner occupied or owned by Local Authority, housing association or other landlord. This includes wardened accommodation but not residential accommodation where health care is provided. It also includes Patients with no fixed abode.</td></tr></tbody></table></div>" }, "entry": [ { "reference": "urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd" }, { "reference": "urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f" } ] } ] }
<Composition xmlns="http://hl7.org/fhir"> <!-- optional elements removed for readability --> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Composition" /> </meta> <status value="final" /> <type> <coding> <system value="http://snomed.info/sct" /> <code value="373942005" /> <display value="Discharge summary" /> </coding> </type> <subject> <reference value="urn:uuid:2c0bca60-1873-46f7-a462-5733feaf32c9" /> </subject> <encounter> <reference value="urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd" /> </encounter> <date value="2023-01-28T10:00:00+00:00" /> <author> <reference value="urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f" /> </author> <title value="Cardiology Service Discharge Summary" /> <section> <title value="Discharge details" /> <code> <coding> <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-RecordStandardHeadings" /> <code value="discharge-details" /> <display value="Discharge details" /> </coding> </code> <text> <status value="additional" /> <div xmlns="http://www.w3.org/1999/xhtml"><table width="100%"><tbody><tr><th>Discharging consultant</th><td><p>Prefix: Dr</p><p>Given Name: Paul</p><p>Family Name: Rastall</p></td></tr><tr><th>Discharging specialty/department</th><td>Cardiology</td></tr><tr><th>Discharge location</th><td><p>Name: Cramer ward</p><p>Identifier: RR8CRAM</p></td></tr><tr><th>Date/time of discharge</th><td>29-Jan-2023 10:58</td></tr><tr><th>Discharge method</th><td>Patient discharged on clinical advice or with clinical consent</td></tr><tr><th>Discharge type</th><td>Usual place of residence unless listed below, for example, a private dwelling whether owner occupied or owned by Local Authority, housing association or other landlord. This includes wardened accommodation but not residential accommodation where health care is provided. It also includes Patients with no fixed abode.</td></tr></tbody></table></div> </text> <entry> <reference value="urn:uuid:5a9f67fa-9343-40cc-8fde-0dd91822b7fd" /> </entry> <entry> <reference value="urn:uuid:2a32666e-84a2-4f90-a6a6-d5451ae2e32f" /> </entry> </section> <!-- other sections removed for readability --> </Composition>
Example Coded Resources
This text section may be linked to a discharging professional UKCore-Practitioner profiled resource. E.g.
{ "resourceType": "Practitioner", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" ] }, "identifier": [ { "system": "https://fhir.hl7.org.uk/Id/gmc-number", "value": "6122477" } ], "name": [ { "family": "Rastall", "given": [ "Paul" ], "prefix": [ "Dr" ] } ], "telecom": [ { "system": "phone", "value": "0113 6323200", "use": "work" } ] }
<Practitioner xmlns="http://hl7.org/fhir"> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" /> </meta> <identifier> <system value="https://fhir.hl7.org.uk/Id/gmc-number" /> <value value="6122477" /> </identifier> <name> <family value="Rastall" /> <given value="Paul" /> <prefix value="Dr" /> </name> <telecom> <system value="phone" /> <value value="0113 6323200" /> <use value="work" /> </telecom> </Practitioner>