Ontario discharge toolkit

Negotiated / AMA Discharge

Harm-reduction leave plan when the person is leaving against advice or on a tight timeline.

Typical use: Public Hospitals Act discharge, capacity intact, risk remains.

Ontario frame, not legal advice. Under the Public Hospitals Act, a person who no longer requires hospital care is generally discharged. The Mental Health Act (Form 1 and related) is a separate, more restrictive path when criteria are met after an examination. Capacity, consent, and substitute decision-making sit in the Health Care Consent Act. Use your organization’s counsel and ethics on live cases. This sheet only records the negotiated safeguards when someone is leaving with risk still present.

Situation

SettingDate / time leaving

Why they want to leave, in their words Risks the team named out loud with them

What we checked before the door

Capacity for this discharge decision considered and documented in the chart (not on this public page) SDM identified if applicable Mental Health Act criteria reviewed by the responsible physician if risk to self/others is active A less-restrictive stay option was offered (pass, room change, withdrawal support, delayed discharge by hours) Prescriptions / OAT / naloxone in hand or refused and noted A same-day or next-day follow-up attempt is assigned to a named worker

Negotiated safeguards

What they agreed to try in the next 24 hours

Who calls them tonight / tomorrow, and whenWhere they say they will be tonightIf things get worse they will…