---
title: "IPD Discharge"
description: "How to discharge an IPD patient — editing the encounter to mark it finished, completing the discharge checklist, and creating the discharge summary."
date: 2026-07-19
lastModified: 2026-07-26
category: "ipd"
author: "Dr. Umesh Bilagi"
beta: false
---

## 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:

| Field | Description |
|-------|-------------|
| **Status** | Change from "in-progress" to **"finished"** to close the encounter. |
| **Disposition** | Dropdown of discharge disposition codes, e.g., "Discharged home," "Transferred to another facility," "Left against medical advice," "Expired." |
| **Date of Discharge** | DateTime picker for when the discharge occurred. |

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:**

| Item | What to verify |
|------|---------------|
| Ready for discharge from hospital | Physician approval for discharge |
| Stable vital signs | Vital signs within normal limits |
| No active infection or complications | Condition improving |
| Prescription of discharge medications | Medications prescribed for post-discharge |
| Explanation of medication to patient | Patient education on medication use |
| Written medication schedule provided | Written plan for medication administration |
| Scheduled follow-up appointment | Appointment set for post-discharge follow-up |
| Patient informed of warning symptoms | Instructions on symptoms to report |
| Emergency contact number provided | Contact information for post-discharge queries |
| Wound care education | Guidance on wound care |
| Dietary recommendations explained | Specific diet instructions |
| Activity restrictions provided | Instructions on physical activity limitations |
| Medical equipment for home use arranged | Devices arranged for home use |
| Delivery of supplies verified | Confirmation supplies are delivered |
| Discharge summary provided | Written summary given to patient |
| Consent forms signed | Consent for discharge obtained |

**Billing tasks:**

| Item | What to verify |
|------|---------------|
| Billing and insurance completed | Financial and insurance tasks finalized |

### 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:

| Section | Source |
|---------|--------|
| **Encounter details** | The IPD encounter (admission date, discharge date, disposition) |
| **ICD coding** | ECTReactComponent for diagnosis coding |
| **Medications** | Medication requests from the encounter |
| **Presenting problems / conditions** | Conditions recorded during the stay |
| **Procedures** | Procedures performed during admission |
| **Follow-up appointments** | Scheduled post-discharge appointments |

### 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](/docs/bill-transaction).