OPD to Discharge: A Hospital Software Workflow Guide

A hospital system works when one patient number follows a person through every counter, and every charge lands on one bill. Here is how that flow should look, step by step, and what to set up so it holds on a busy day.

Step 1: Registration at the front desk

Registration should take under a minute for a returning patient. The receptionist searches by phone number, name or patient number. If a match appears, they confirm and move on. If not, they create a new record with name, age or date of birth, sex, address, phone and a guardian contact for children and elderly patients.

Two settings help here: a duplicate warning when name and phone closely match an existing record, and a rule on how to enter dates. Many Nepali patients know their date of birth in Bikram Sambat, so the entry screen should accept BS and store AD in the background.

Step 2: OPD ticket and queue

The ticket links the patient to a doctor and a fee. Set consultation fees per doctor and a follow-up window, for example a free or reduced revisit within a number of days that your management decides. The queue screen for each doctor shows who is waiting so the doctor calls the next person without a runner carrying slips.

If your hospital sees large crowds in the morning, pair this with a token display so families know the order and the counter is calmer.

Step 3: Consultation and orders

The doctor notes the visit and, where needed, orders investigations or admission. For lab and radiology, the order goes to the relevant department with the patient number attached. The patient then pays at billing, or the charge is held against the admission if they are being admitted.

• Doctor sees the patient list and history for that visit.
• Orders create pending charges automatically.
• Paper chits for lab requests are no longer needed, which removes a common cause of mixed-up samples.

Step 4: Investigations and results

Lab staff see a work list, record the sample against the patient and enter results. The report prints with your letterhead and, if you choose, is shared with the patient by message. The doctor can view the result from the consultation screen. Radiology works the same way, with a report attached as a file or entered as text.

Step 5: Admission and bed allocation

When a patient is admitted, the system captures the admitting doctor, ward, bed, deposit and attendant contact. The bed board then shows occupied, vacant and reserved beds. Transfers between wards are recorded with dates so bed-day charges follow the patient.

Think about what happens when a bed is cleaned or out of service. A status for that avoids assigning a bed that is not ready.

Step 6: Charges during the stay

This is where hospitals usually lose money. During admission, charges come from several places:

1. Daily bed or ward charges, posted automatically.
2. Doctor visits and procedures entered by the ward.
3. Lab and radiology orders.
4. Medicines and consumables issued from the pharmacy to the ward.
5. Deposits and part payments received.

When each of these posts to the admission at the time it happens, the running bill is always visible. Families can be told the amount to date without anyone adding slips by hand, and the cashier is not surprised on discharge day.

Step 7: Discharge and final bill

On discharge the doctor completes the summary, the ward confirms returns of unused medicines, and billing closes the account. Discounts or concessions require a reason and a user, which keeps the process fair and traceable. The final bill lists everything with deposits deducted and shows the balance or refund.

Print a clear copy for the family and keep a digital copy linked to the patient number for later queries.

Handling the awkward cases

Real days are not tidy, and your set-up should expect the exceptions.

• Emergency arrivals. A patient may arrive without a name or a family member. Allow a temporary registration that can be completed and merged later, so treatment is never delayed by data entry.
• Refunds and cancellations. A cancelled ticket or returned medicine should reverse the original entry with a reason, not delete it. This keeps the cash closing honest.
• Referral in and out. Record where the patient came from and where they were sent, which helps later reporting.
• Leave against advice or death. Discharge types should be recorded as the hospital requires, with the bill settled or marked as due, so statistics remain consistent.
• Late charges. If a charge is found after discharge, a controlled supplementary bill with approval is better than an informal cash arrangement.

Agree these rules with management before go-live and write them down. Software can enforce a rule only after someone has decided it.

Step 8: End-of-day closing

Each cashier closes their counter, the system compares expected cash to counted cash and reports differences. Management sees collections by department and mode of payment. This is also the time for backups.

Set-up checklist before go-live

• Doctor list with fees and follow-up rules.
• Complete tariff list for bed, procedures, lab and radiology.
• Ward and bed master with categories.
• Pharmacy items with opening stock, batch and expiry.
• User roles for reception, cashier, nurse, doctor, pharmacy and admin.
• Print formats for receipts, bills, lab reports and discharge summary.

Next step

Take one real admitted patient from last month and replay it through a demo. If the final bill matches your manual one, or finds charges you missed, you have a useful test. WebsNP will set this up for you in our hospital management software demo. Message +977 9846280400 on WhatsApp with your tariff list.

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