1. Open Packet Navigation from your preferred templates and add the program. 
  2. Click to open the 'Transfer Summary' (BH) template from Packet Navigation.
  3. The discharge date will auto-populate depending on the encounter being used. If the date is not accurate, close the template without saving and go to the correct encounter to open the template. 
  4. Click on the radio button to close the program that is listed in the program field on the template 
  5. Click on the radio button that best fits the status reason for the discharge. 

Assessment/Diagnosis

  1. If the client has a diagnosis, you will click the 'Active Diagnosis' link; highlight a diagnosis from the active diagnosis grid; click Add to Grid; click close. If the client does not have a diagnosis you will click on the 'Diagnosis Code Lookup' link and search for the diagnosis, highlight the diagnosis in the list and click select.

 

 

  1. If there is more than one Active Diagnosis in the active diagnosis list add them (if applicable)

A picture containing chart Description automatically generated

  1. Add 'Status, Severity, Impression and Specifier' (only add information to these sections if it is applicable)
  2. If the diagnosis in the grid needs to be re-organized - click the sort of button on the bottom to arrange them in the order needed.
  3. Click on the 'Psychosocial Stressors link to open that window and document the information for that section (if applicable) click save and close to return to the template.

 

Graphical user interface, text, application, email Description automatically generated

 

 

  1. Click on the 'WHO Disability Assessment Schedule 2.0' link to open that template.

Table Description automatically generated with medium confidence

 

  1. Click in the radio button that best answers each question, click save and close to return to the template.

 

Discharge Summary

  1. Click 'Modality/frequency' field and add a comment.
  2. Click 'Duration' field and add a comment click 'Compliance' field and add a comment.
  3. Click 'Focus of treatment' field and add a comment.
  4. Click 'Were treatment goals achieved' field and add a comment.
  5. Click 'Family supports' field and add a comment.
  6. Click 'Community Supports' field and add a comment.
  7. Click 'Agencies Involved' field and add a comment.
  8. Click 'Follow up' field and add a comment.
  9. Discharge Risk Assessment: Click in the boxes that best fit the discharge risks Substance Use: Click in the boxes that best fit the substance use of the patient.
  10. Click in the 'Reason for Discharge' field, select from the picklist, click ok.
  11. Click 'Discharge Destination' field, select from the picklist, click ok.
  12. Complete the remaining destination type information if applicable.

**KEYNOTE- Goals will need to be addressed in the Integrated Service Plan before completing the 'Discharge Summary' for the patient so it reflects the status accurately for the goals listed.

  1. Review Goals addressed during selected Program Dates.

 

Discharge Plan  

*If applicable you can print the 'Medication List' and 'Patient Education' for the patient.

  1. Click the Plan/instructions field and add a comment as needed.

*If applicable you can review the 'Labs' and 'Add Plan Instructions' for the patient.

Signature (Tasking Supervisor/Staff for review and signoff)

**Do Not Add Your Name to the Grid if you are tasking to supervisor.

  1. Click the 'Generate Document' button - if the document does not auto-generate.
  2. Review the document for accuracy.