Before you go, it is a good idea to create a list of things you will need once you leave. We believe that discharge planning starts from the day of admission with daily patient education and a coordinated interdisciplinary team approach. You and your caregiver(s) – family member or friend who may be helping you – are important members of the planning team. Primary care a. Hospital/hospice staff must prioritise the discharge as URGENT to minimise any potential delays. Check if you have sufficient money with you for the first few days out of hospital. [32, 33] Examples of scenarios where teach‐back would be of benefit include changes in medications with a high risk of adverse events, such as warfarin or furosemide, to ensure patients understand the dosing, frequency, and monitoring required; and self‐management skills (eg, daily weights and dietary changes) in patients with heart failure.Finally, the panel noted that it was important to link the checklist items with relevant measures, audit, and feedback to determine associations between process and outcomes. Medication safety a. The panel chose daily reminders to perform patient education around medications and clinical care for several reasons. For those without a PCP, it was recommended that a search should be initiated to assist the patient in obtaining a PCP. Do I need care from family members? Finally, our proposed tool better follows a recommended checklist format. The panel reached 100% agreement on the recommended timeline to implement elements of the discharge checklist. Halasyamani and colleagues developed a checklist for elderly inpatients created through a process of literature and peer review followed by a panel discussion at the Society of Hospital Medicine Annual Meeting. helps to make sure that you leave the hospital safely and smoothly and get the right care Conduct COVID-19 Discharge checklist conversation as per Appendix D script. We have used a consensus process of stakeholders to develop a Checklist of Safe Discharge Practices for Hospital Patients that details the steps of events that need to be completed for every day of a typical hospitalization. [10]Beginning in 2012, the Centers for Medicare and Medicaid Services will be reducing payments to facilities with high rates of readmissions. RESULTSEvidence‐based interventions pre‐, post‐, and bridging discharge were categorized into 7 domains: (1) indication for hospitalization, (2) primary care, (3) medication safety, (4) follow‐up plans, (5) home‐care referral, (6) communication with outpatient providers, and (7) patient education (Table 1). d. Explain potential symptoms, what to expect while at home, and under what circumstances patient should visit ED. [4, 5, 6] Discharge bundles (multifaceted interventions including patient education, structured discharge planning, medication reconciliation, and follow‐up visits or phone calls) are strategies that provide support to patients returning home and facilitate transfer of information to primary‐care providers (PCPs). Write down information about support groups. Engage home‐care agencies (eg, interdisciplinary rounds). The day of discharge is often a confusing and chaotic time, with patients receiving an overwhelming volume of information on their last day in the hospital. Engage home‐care agencies (eg, interdisciplinary rounds). Patient identifies if family or friends need to be involved. The UK’s 100 favourite books in 2015 Checklist. We suggest using the checklist during daily interprofessional team rounds to ensure each task is completed, if appropriate. [11] Thus, improving care transitions and thereby reducing avoidable readmissions are now priorities in many jurisdictions in the United States. [32, 33] Examples of scenarios where teach‐back would be of benefit include changes in medications with a high risk of adverse events, such as warfarin or furosemide, to ensure patients understand the dosing, frequency, and monitoring required; and self‐management skills (eg, daily weights and dietary changes) in patients with heart failure. Contact PCP and notify of patient's admission, diagnosis, and predicted discharge date. In addition, high‐risk patients may require an earlier follow‐up appointment with the PCP, and the panel supports attempts to arrange follow‐up within 7 days for at‐risk individuals. 10-Point Hospital Discharge Checklist Get the information you need to help ensure a successful recovery after a hospital stay. Teach patient how to properly use discharge medications and how these relate to the medications patient was taking prior to admission. 6. Future studies to evaluate the checklist in improving care‐transition processes are required to determine association with outcomes.DisclosuresNothing to report. a.Perform postdischarge follow‐up phone call to patient (for patients with high LACE scores. Get prescriptions and any special diet instructions early, so you won’t have to make extra trips after discharge. [12] The Ontario Ministry of Health and Long‐Term Care convened an expert advisory panel with a mandate to provide guidance on evidence‐based practices that ensure efficient, effective, safe, and patient‐centered care transitions. Hospital Discharge Checklist Here are ten important things to consider when preparing for a hospital discharge: 1.Safety – Is your home a safe place for your recovery? Offer to make followup appointments. [7, 9, 15, 31] The panel incorporated these elements by recommending performing postdischarge phone calls, arranging outpatient follow‐up if necessary, and coordinating home‐care services through local agencies.To facilitate transfer of information, patients, caregivers, outpatient providers, and community pharmacies are to be provided copies of a comprehensive discharge summary, medication reconciliation, and contact information of the inpatient team under the category of Communication. Hospital Discharge Checklist. A discharge‐checklist tool was created to facilitate safe discharge from hospital. A final meeting provided consensus of the panel on every element of the Safe Discharge Practices Checklist. This differs significantly from our discharge checklist, which provides specific recommendations on methods and processes to effect a safe discharge in addition to an expected timeline of when to complete each step. Good planning helps you feel prepared for discharge, and helps you to continue your recovery once you leave the hospital. Identify and/or confirm patient has an active PCP; alert care team if no PCP and/or begin PCP search. There is a similar focus on readmission rates in the province of Ontario. During the meeting, panel members were assigned to 1 of 6 groups (based on specialty area) and instructed to review toolkits and literature using a context‐specific lens (primary care, home care, follow‐up plans, communication to providers and caregivers, medication, and education). b. Discharge Planning and Outcomes Measurement A discharge planning checklist can give you a sense of how intensive recovery will be for a client and how much effort will likely be needed to ensure good outcomes. Be sure you tell the staff what you prefer. b. Our discharge checklist prompts hospital providers to initiate steps necessary for a successful discharge while allowing for local adaptation in how each element is performed. b. [13] The objective of this study is to describe a structured panel approach to safe discharge practices, including a checklist of a recommended sequence of steps that can be followed throughout the hospital stay. Patients, family caregivers, and healthcare providers all play roles in maintaining a patient ʼ s health after discharge. [3] Use of validated scores such as the LACE index (a score calculated based on 4 factors: [L] length of hospital stay, [A] acuity on admission, [C] comorbidity, and [E] emergency department visits) to identify patients at high risk of readmission and targeting these individuals when arranging postdischarge follow‐up is encouraged. [7, 8, 9] These interventions collectively may improve patient satisfaction and possibly reduce rehospitalization. Write down where to call if you have questions about equipment. Standardizing discharge planning and initiating processes early on in a patient's hospital stay may ensure a safe transition home. Formal medication reconciliation programs should be tailored to the individual hospital's own resources and requirements. First, current literature on safe discharge practices is limited by low study‐design quality, with a paucity of randomized controlled trials. a. Assess patient to see if hospitalization is still required. weight loss. The final checklist describes the processes necessary for a safe and optimal discharge and recommended timeline of when to complete each step, starting from the first day of admission. The Checklist of Safe Discharge Practices for Hospital Patients summarizes the sequence of events that need to be completed throughout a typical hospitalization. [24, 25] Patients with high LACE scores (10) would benefit from postdischarge follow‐up phone calls within the first 3 days of returning home. a. The panel met 3 times in person over a period of 3 months, from January 2011 to March 2011. Discharge checklist and follow-up phone calls: the foundation to an effective discharge process Shari Aman, BSN, RN, MBA, CPHQ Denise Andrews, MBA Stephanie Storie, BSN, RN, CMSRN Deb Nation, RN, CMSRN. Hospital Leave a comment 565 Views. Continue reading →, Your email address will not be published. To create an evidence‐based checklist of safe discharge practices for hospital patients. Institutions may consider measuring process measures such as adherence and completion of checklist, audits of discharge summaries for completion and transmission rates to PCPs (by fax or through health record departments), and documentation of patient education or medication reconciliation. Communication a. Our discharge checklist is an expanded tool that provides explicit guidance for each day of hospitalization and can be adapted for any hospital admission to aid interdisciplinary efforts toward a successful discharge. Although education starting on day 1 of admission may seem premature, we felt there was merit in addressing issues early. Patient education a. Hospital Discharge Checklist. [2, 26, 27, 28] The discharge checklist provides prompts to reconcile medications on admission and discharge, in addition to daily patient education on proper use of medications. Discharge from the hospital is a point of care requiring clear communication and a coordinated effort from the entire team. [20] were examined in detail. Daily teaching provides an opportunity to assess information carried over and accurate understanding of treatment plans, as well as to review changes in care plans that may be evolving during a hospitalization. a. Home‐care agency shares information, where available, about patient's existing community services. To develop a best‐practice discharge checklist for hospital patients using the Electronic Medical Record (EMR) (EPIC, Verona, WI), and evaluate its usage, user‐satisfaction, and impact on physicians’ workflow. A score of 10+ indicates high risk for readmission to hospital.bTeach‐back is the process of explaining information to patients and asking them to restate the information to assess accuracy. It was also felt that daily interdisciplinary (ie, bullet) rounds would serve as the most appropriate venue to utilize the checklist tool.Table 1.Checklist of Safe Discharge Practices for Hospital Patients Day of AdmissionSubsequent Hospital DaysDischarge DayDischarge Day +3NOTE: Abbreviations: BPMH, best possible medication history; ED, emergency department; LTC, long‐term care, PCP, primary care physician.aLACE index is a score calculated based on 4 factors: (L) length of hospital stay, (A) acuity on admission, (C) comorbidity, and (E) ED visits. However, a recent systematic review found that bundled discharge interventions are likely to be most effective. Bring this information and your completed “My Drug List” to your follow-up appointments. Often, transfer of important information and medication review take place only hours before a patient leaves the hospital, a suboptimal time for patient education. Example outcome measures, if feasible, include Care Transitions Measure (CTM) scores, patient satisfaction surveys, and readmission rates. Our HF readmission rate at our institution was as high as 25.5% in 2011. Journal of Hospital Medicine 2013;8:444–449. Save my name, email, and website in this browser for the next time I comment. We searched Medline (through January 2011) for relevant articles. Write down a name and phone number to call if you have problems. Every group reached consensus on items specific to its context. For example, PCPs in group 1 were asked to consider an ideal discharge from the perspective of primary care. Do you have any questions about the items on this checklist or on the discharge instructions? Teach patient how to properly use discharge medications and how these relate to the medications patient was taking prior to admission. Twenty‐seven percent still had edema at discharge. c. If necessary, book specialty‐clinic follow‐up appointment. 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