During discharge, what sequence ensures new outpatient orders can be linked to active problems?

• A. Create orders and resolve problems simultaneously
• B. Create new outpatient orders first, because they may need to be linked to active problems
• C. Resolve problems first, then create orders
• D. Do not create orders at discharge

Answer: (B)

When finalizing discharge, you want any new outpatient orders to be attached to the patient’s active problems. Creating the new outpatient orders first allows you to link them directly to the active problem(s) because those problems are still open. After the orders are linked, you can then resolve the problems as appropriate for the discharge summary.

If problems are resolved first, they’re no longer active, so linking the new orders to those problems becomes difficult or impossible, which can leave the orders orphaned or poorly connected to the care plan. Not creating orders at discharge misses the opportunity to convey the intended outpatient follow-up and treatments.

So, the best sequence is to create new outpatient orders first, since they may need to be linked to active problems, and then resolve problems as part of completing the discharge.