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Criteria Led Discharge

A patient's transfer of care (discharge) from hospital can be delayed for many reasons. We know from patient surveys and published research that patients can wait unnecessarily for discharge once they are medically cleared to leave the hospital. Criteria Led Discharge ( CLD ) is a process to ensure patients can return home from hospital as safely and quickly as possible.

What is best practice for Criteria Led Discharge?

Under CLD the decision for discharge is made and documented by the senior medical clinician (e.g. Senior Consultant, Medical Fellow, Visiting Medical Officer). Additional criteria may be added by the interdisciplinary team members.

For appropriate patients CLD competent staff (e.g. nursing, allied health, junior medical officer) can then facilitate the discharge of a patient according to documented criteria. The CLD competent staff member is responsible for monitoring that the CLD criteria have been met.

Best practice for CLD is:

  • To identify a patient as eligible for CLD on admission (or pre-admission for planned admissions).
  • To continue to review patients every day by the medical team and update the set criteria, if required.
  • To agree the criteria and subsequent plan for discharge in partnership with the entire health care team, including the patient and/or their carer.
  • For the CLD competent staff member to monitor and record if the patient has met the criteria. This does not substitute for clinical judgement and if a patient does not meet the criteria a medical review is necessary.
  • For a transfer of care (discharge) checklist to be completed for all patients, this should include a section on patient education that has been provided.

Goals of Criteria Led Discharge

  1. Improved patient and staff experience
  2. Improved communication
    • Better informed patients
    • Transparency on the discharge plan for the entire team
  3. Improved efficiency
    • Early decisions leading to smooth discharge
    • Reduced length of stay
    • Increased weekend transfers (discharge) of care
    • No increase in readmission rates

What resources are available for Criteria Led Discharge?

Criteria Led Discharge Toolkit - A resource to support the implementation of CLD

This toolkit (PDF 2.7MB) gives a brief overview of CLD and describes the resources available to assist sites to:

  • assess their readiness for CLD implementation
  • create a governance structure
  • plan implementation
  • create CLD resources
  • train staff
  • educate patients
  • collect indicators
  • assess outcomes

Download the appendices from the toolkit separately (zip 4.6MB) or .

For further information please contact Sue Schasser.

Further resources

The ACI Acute Care Taskforce has developed a set of resources to support the implementation of CLD .

They include:

Download the complete set of resources (ZIP file - 3.7Mb)

CLD for Mental Health Inpatients

Work has begun on including the CLD model within Inpatient Mental Health wards.

ACI Acute Care taskforce, ACI Mental Health Network and Whole of Health Program - Mental Health Project together with interested inpatient units have collaborated to develop:

For further information or to get involved please contact:

Sue Schasser, Manager, Acute Care on 02 9464 4623 or sue.schasser@health.nsw.gov.au

Linda Hassett, Manager, Mental Health on 02 9464 4680 or linda.hassett@health.nsw.gov.au

Local Innovations for Criteria Led Discharge

Since early 2014 teams have been developing a local approach to improving patient care through more standardised discharge practices. Some of the local innovations are listed below. If you would like your CLD form added to these innovations please email Sue Schasser, Manager, Acute Care on sue.schasser@health.nsw.gov.au.

CLD forms:

Dubbo Hospital has also developed a revised CLD patient leaflet (testing draft).

Royal Prince Alfred Hospital has adapted the CLD process to develop criteria for transfer to Balmain Hospital from RPA Geriatric Medicine. This form clearly outlines the process for transfer and the criteria for transfer. A PDF version of the form can be downloaded: Criteria Led Transfers between RPA and Balmain Hospital.

Where can I get more information about support for implementing Criteria Led Discharge?

Testing of the CLD resources in NSW began in August 2013 and the ACI Acute Care Taskforce has been supporting teams implementing CLD since early 2014. For more information contact Sue Schasser, Manager, Acute Care on 02 9464 4623 or sue.schasser@health.nsw.gov.au