Rawesome Vets · Internal Staff Protocol

Discharge Protocol

Nursing Team

Reception Surgery

Version 1.0 · May 2026 · For internal staff use

1. Before the Client Arrives

Discharge should not happen at the desk without preparation. Before the client comes in, make sure everything is ready.

Invoice — review with the vet that all charges are on the invoice and nothing is missing.
Paperwork — discharge notes and any consent or treatment summaries are printed and ready.
Medications — made up, labelled with the patient's name, dose, and instructions. Ready to hand over.

Charges must be communicated during the day — not left as a surprise at discharge. If additional charges were added during the procedure, the client should have been notified by phone. A discharge surprise is a clinic process failure, not just a client complaint.

2. Nurse vs Vet Discharge

Nurse discharge	Vet discharge required
Routine desexings	X-rays were taken — vet needs to show the client the images and explain findings
Procedures where the vet has already spoken to the client by phone about the outcome and plan	Complicated diagnosis or treatment plan — client needs to be on board and fully understand the plan before leaving
Routine procedures with no unexpected findings	Any accident or complication during the procedure
	Unexpected outcome or poor prognosis

3. Nurse Discharge — Step by Step

Have paperwork, invoice, and medications ready before the client arrives.
Greet the client and go through the paperwork — explain what was done during the procedure.
Take full payment first, then hand over the patient.
Go through all medications and instructions (see Section 5).
Book the recheck appointment (see Section 6).
Check the client is comfortable: "Do you have any other questions? Are you happy with the plan?"
Farewell the client and patient.

4. Vet Discharge — Step by Step

Vet discharges must be communicated to the client by phone and booked into the afternoon or discharge appointment slots in OpenVPMS — not handled as a walk-in.

When the client arrives, show them into a consult room.
Do not bring the patient into the room during the vet discussion. It is much easier to have a clear conversation without the animal present.
The vet walks through findings, images, diagnosis, and the plan with the client in the room.
Once the vet is finished, the client comes to the front desk.
The nurse takes payment and goes through medications (see Section 5).
Book the recheck appointment (see Section 6).
Hand over the patient.

5. Medications & Instructions

Go through every medication with the client clearly. Do not hand over a bag and assume they will read the label.

For each medication, cover all of the following:

Storage — does it need to go in the fridge?
When to start — today, after food, tomorrow morning?
Dose and how often
When to stop — finish the course, or stop after X days?
Side effects to watch for

Go through all post-operative care instructions. Encourage the client to call us if they have any concerns at all — we would rather hear from them than have them worry at home.

Recheck visits

Post-op rechecks are free of charge. If medications are needed at the recheck appointment, those will have a charge. Let the client know so there are no surprises.

6. Booking the Recheck

Book the recheck at the time of discharge — do not leave it to the client to call and organise.

Open OpenVPMS and book the recheck appointment before the client leaves the desk.
Confirm the date and time with the client.
Remind them it is a free check — we just want to make sure everything is healing well.

7. Payment Disputes — Decision Guide

Before using this guide: Check whether the additional charges were communicated to the client during the day. If they were not — that is a clinic process error. Acknowledge this calmly and follow the appropriate path below.

Scenario	First response	If resolved	If not resolved	Discount?
More than expected — sticker shock	Walk through each line item on the invoice. Reference the signed consent form and estimate. Explain what each charge is for.	Client understands and pays	Vet on duty goes through the same process with the client	No
Quoted less / wrong amount	Check consent form — was a quote recorded? Identify whether this was a clinic error or a misremembering	Clinic error confirmed → vet on duty authorises adjustment	Client misremembered + signed form exists → vet on duty explains	Only if confirmed clinic error, vet authorises
Charge wasn't discussed	Check consent form — was it listed and signed for?	Yes, it was on the form → walk through it calmly	Not on form → escalate to vet on duty to review and decide	Only if vet authorises
Can't afford it today	Offer VetPay or Zip Pay as alternatives (advise admin fee applies for VetPay)	Client accepts alternative payment method	Pet is not released — alert management immediately	No
Something went wrong / unhappy with outcome	Show the client into a room — give them privacy. Do not handle this at the front desk. Listen carefully. Identify what they are unhappy about and what they are asking for. This may not be clear straight away.	See breakdown below		See breakdown below

When something goes wrong — sub-scenarios

Situation	Who attends	What happens	Charge?
Patient dies unexpectedly under our care	Experienced nurse OR vet on duty — must attend immediately	Listen and support. Do not rush the conversation. Do not leave the client alone.	No charge whatsoever
Our fault identified — good outcome	Vet on duty	Vet acknowledges the situation. Vet on duty may authorise a discount.	At most 10% — vet on duty authorises
Our fault identified — bad outcome	Senior vet + practice manager	Escalate immediately. Do not attempt to resolve independently. Do not make any commitments.	To be determined by senior vet and practice manager
Client unhappy — no clear fault identified	Vet on duty	Listen, identify what the client wants, escalate to vet on duty. Do not offer discounts or make commitments.	No — not until vet reviews

Hard rules — all scenarios:

The patient is not released until payment is made in full, or management has explicitly authorised an exception
Charges are never removed without vet authorisation
Team does not make clinical admissions
All disputes and their resolution must be noted on the client account — include date and your initials

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