{"id":6322,"date":"2023-10-24T08:15:24","date_gmt":"2023-10-24T14:15:24","guid":{"rendered":"http:\/\/partnershiphome.net\/new\/?page_id=6322"},"modified":"2025-04-05T01:53:29","modified_gmt":"2025-04-05T01:53:29","slug":"discharge-planning","status":"publish","type":"page","link":"https:\/\/partnershiphome.net\/new\/discharge-planning\/","title":{"rendered":"Discharge Planning"},"content":{"rendered":"
[vc_row full_width=”stretch_row_content” css=”.vc_custom_1738482123941{padding-top: 40px !important;}”][vc_column][vc_custom_heading text=”DISCHARGE PLANNING” font_container=”tag:h2|text_align:left|color:%231D5EA2″ use_theme_fonts=”yes” css=”” el_class=”red”][vc_column_text css=””]The TX-601 CoC is working in coordination with hospital districts and shelters to better align expectations for patients who are discharged from healthcare facilities to homeless shelters in Tarrant County. The intended audience for this guidance includes hospital staff, nursing facilities, medical transportation organizations or anyone assisting a patient transitioning from a healthcare facility to a homeless situation.<\/p>\n

To assist during the discharge process, the TX-601 CoC Hospital Discharge Committee has developed new tools and guidance all of which are available on this page.<\/p>\n

It is recommended to review all documents before discharging a patient experiencing homelessness:<\/p>\n

HOSPITAL DISCHARGE FORM<\/a><\/strong><\/p>\n

HOSPITAL DISCHARGE TIPS<\/a><\/strong>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=”stretch_row_content” css=”.vc_custom_1738482131529{padding-top: 40px !important;background-color: #dfe0e6 !important;}”][vc_column][vc_custom_heading text=”STANDARD OPERATING PROCEDURE” font_container=”tag:h2|text_align:left|color:%231D5EA2″ use_theme_fonts=”yes” css=”” el_class=”blue”][vc_column_text css=””]The purpose of this Standard Operating Procedure (SOP) is to provide clear and consistent guidance for hospital to discharge people experiencing homelessness. This SOP is designed to ensure that people experiencing homelessness are discharged safely with access to appropriate resources and to reduce the likelihood of readmission.<\/p>\n

Scope:<\/strong><\/p>\n

This SOP is recommended by the TX-601 CoC Hospital Discharge Committee to all hospitals in Tarrant County discharging people experiencing homelessness.<\/p>\n

Procedure:<\/strong><\/p>\n

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  1. Identify patients experiencing homelessness through standard hospital screening and assessment.<\/li>\n
  2. Use the Hospital Discharge Tips and Hospital Discharge Form to assess the patient\u2019s needs, including shelter, food, clothing, and transportation.<\/li>\n
  3. Coordinate with partner agencies using the SHELTER AND OUTREACH INFORMATION<\/a><\/strong>, Shelter Screening Tool, and Other resources to plan for safe and appropriate discharge.<\/li>\n
  4. Ensure the patient has a follow up appointment scheduled at True Worth Medical Home, unless the patient has another PCP they see regularly.<\/li>\n
  5. If the patient is already in a shelter program, contact their case manager.<\/li>\n
  6. Ensure all assessments, discharge plans, and follow up communication are documented in the patient\u2019s medical record.<\/li>\n<\/ol>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=”stretch_row_content” css=”.vc_custom_1738482140538{padding-top: 40px !important;}”][vc_column][vc_custom_heading text=”SHELTER AND OUTREACH INFORMATION” font_container=”tag:h2|text_align:left|color:%231D5EA2″ use_theme_fonts=”yes” css=”” el_class=”red”][vc_column_text]All shelters require that clients be fully, independently able to safely:<\/p>\n