Department of Health

Application of the toolkit

An overview of the Criteria Led Discharge Toolkit explaining what it is and what the benefits are.

Introduction

Delivering efficient high-quality and safe care for all Victorians involves maintaining optimal flow through the system while enhancing health outcomes and consumer experiences. The discharge and transfer of care processes are key to this, aiming to get patients home as soon as safe and appropriate for them, thus ensuring bed availability for those who need them. Criteria Led Discharge (CLD) is an effective solution which reduces Length of Stay (LOS) and empowers staff and consumers. This tool kit aims to support health services to safely introduce, sustain and spread CLD.

What is CLD?

CLD is a process that empowers a trained member of the Multidisciplinary Team (MDT) to discharge a patient when they meet pre-agreed clinical criteria. This removes the need for the patient to wait for the Surgeon (e.g. consultant/senior registrar) to approve discharge. CLD should not replace post operative review of the patient by the surgical team or impact the ability of the patient to ask those present in the operating room questions about their surgery. CLD streamlines the discharge/transfer from the beginning of the patient journey. It also empowers and incorporates the patient and family/support person in discharge planning.

Benefits of CLD

CLD can improve:

  • the coordination of patient care
  • communication across the team, including GP/primary care, patients and carers
  • patient flow within wards and across the hospital setting
  • consumer experience and outcomes
  • length of stay by reducing unnecessary bed days
  • effective use of resources
  • staff satisfaction.

Primary CLD process flow chart

Primary Criteria Led Discharge process flow chart
Primary CLD process flow chart

Patient admitted

↓

CCD and EDD confirmed/identified and recorded

↓

Care provided by MDT (Multidisciplinary Team)

Surgeon/Medical: is patient suitable for CLD?

  • NO
    → Surgeon/Medical review patient
    → MDT: could patient not be suitable for CLD?
    → YES
    → Surgeon/Medical remains responsible for discharge
    → NO
    → Concerns escalated to Surgeon/Medical
  • YES
    → Care provided by MDT, monitoring patient against CCD

↓

MDT member: has the patient met CCD?

  • NO
    → Concerns escalated to Surgeon/Medical
  • YES
    → MDT: any other concerns? Or patient has concerns about discharge?
    • NO
      → Patient discharge by MDT member
    • YES
      → Concerns escalated to Surgeon/Medical

Key terms:

  • CCD: Criteria for Clinical Discharge
  • EDD: Estimated Date of Discharge
  • CLD: Continuous Length of Stay
  • MDT: Multidisciplinary Team

This flowchart visualizes decision points and processes for evaluating whether a patient is suitable for CLD and what steps should be followed for their discharge, involving assessments by the MDT and medical reviews where necessary.

Download Primary CLD process flow chart

Successful CLD involves not only discharging suitable patients according to established criteria but also identifying when patients are no longer appropriate for discharge and appropriately escalating their care.

Reviewed 01 November 2024

Criteria Led Discharge Toolkit

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