Occupational Therapy · Discharge letter · Beginner

Occupational Therapy — Discharge to GP after Total Hip Replacement

An occupational therapist discharges a 74-year-old woman to the GP following a total hip replacement. This beginner case requires communicating the hip precautions, the ADL status, and the home equipment provided so the GP has a complete picture of the patient's functional status at discharge.

Letter type

Discharge

Write to

General Practitioner

Target length

160–180 words

The case notes

Patient: Mrs Kathleen Doyle, 74 years old; right total hip replacement (posterior approach) yesterday; discharged home today with support from her husband

Hip precautions (12 weeks): Do not bend the right hip beyond 90 degrees; do not cross legs; do not twist or rotate the right hip inward; these precautions prevent posterior dislocation

ADL status: Independent in: walking with a frame (short distances), bed transfers with rail; Assistance required: dressing lower body (hip precautions prevent bending to put on socks/shoes); showering (showering stool provided)

Equipment provided: Walking frame; raised toilet seat (7 cm); showering stool; long-handled shoe horn and sock aid; bed rail

Follow-up: Physiotherapy outpatient booked at 4 weeks; hip precautions review with surgeon at 12 weeks

Task: Write a discharge letter to the GP, Dr Michael Burke, outlining the hip precautions, ADL status, and equipment provided.

Writing task

Write a discharge letter to the GP, Dr Michael Burke, outlining the hip precautions, ADL status, and equipment provided.

What to include, what to cut

The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.

Include

  • The three hip precautions (no hip flexion beyond 90°, no leg crossing, no inward rotation) and their purpose

    Posterior dislocation of a new hip replacement is a serious complication. The GP must know the precautions to support the patient's compliance and to recognise if the patient is at risk.

  • Equipment provided: walking frame, raised toilet seat, showering stool, sock aid

    The GP needs to know what the patient has at home so they can assess compliance and identify gaps at the post-op review.

  • That dressing lower body requires assistance and the husband is providing support

    The patient is not fully independent — the GP needs to know the carer situation in case the husband is unavailable.

Leave out

  • The surgical approach (posterior) in detail

    'Right total hip replacement (posterior approach)' is one clause of context — it explains why the hip precautions are those specific movements. No further surgical detail is needed.

  • The physiotherapy follow-up detail

    State it in one sentence: 'Physiotherapy outpatient booked at 4 weeks.' The GP does not manage the physiotherapy schedule.

Criterion in focus · Content

A hip replacement OT discharge letter has three non-negotiable Content requirements: (1) the precautions stated precisely (the three specific movements, not just 'hip precautions apply'), (2) the current ADL independence level, (3) the equipment in place. Omitting the specific movement restrictions, stating 'equipment was issued' without listing it, or omitting whether the patient has carer support are all Content gaps.

Now write the letter — and find out what is blocking your Grade B

Write a 160–180 words discharge letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.

Questions about this case note

What are posterior hip precautions and why do they matter to an OT?
After a total hip replacement performed via the posterior approach, the hip joint capsule has been cut and repaired. Until it heals (approximately 12 weeks), the hip is at risk of dislocation if the patient bends the hip beyond 90°, crosses their legs, or rotates the hip inward — the three movements that stress the posterior capsule repair. OTs design ADL adaptations (raised toilet seat, sock aid, showering stool) that allow self-care within these constraints.
Should I include the patient's pain level in an OT discharge letter?
Only if it affects ADL function or compliance with equipment. Post-operative pain that is controlled and not affecting mobility or precaution compliance can be omitted — the surgical team manages pain. If pain is preventing mobilisation or the patient is avoiding using equipment, a brief mention is appropriate.

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