Share 10-Point Hospital Discharge Checklist . Assess patient’s ability and access to use virtual communication services for follow up and home care supports. Ask to speak to a social worker if you’re concerned about how you and your family are coping with your illness. 6. Write down a name and phone number to call if you have problems. Email Marketing Checklist – use this to increase sales! First, current literature on safe discharge practices is limited by low study‐design quality, with a paucity of randomized controlled trials. [28, 35] Just as standardized treatment protocols and care plans can improve outcomes,[36] a similar approach for discharge processes may facilitate safe transition from hospital to home. Finally, as the teach‐back method is an effective tool to ensure patient understanding of their health issues, the panel recommended its use when educating patients on medication use, plan of care, and discharge instructions. Following the meeting, each group communicated via e‐mail to generate a list of evidence‐based items necessary for a safe discharge within the context of the group's assigned lens. Finally, our proposed tool better follows a recommended checklist format.[21]. 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. Think about any stairs, steps, or other mobility challenges inside your home and create a plan for how you will deal with them. Here are some questions you could ask yourself before you are discharged from hospital: 1. 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). Description: We reviewed the literature and consulted with physician‐leaders at our academic medical center to develop a checklist. 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. The panel met 3 times in person over a period of 3 months, from January 2011 to March 2011. 5. b. 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. Standard hospital newborn tests and procedures after birth Erythromycin eye ointment; Vitamin K injection; Hepatitis B vaccine; New born bath Hospital newborn tests and procedures before discharge. Write down any appointments and tests you will need in the next several weeks. weight loss. However, a recent systematic review found that bundled discharge interventions are likely to be most effective. We believe that discharge planning starts from the day of admission with daily patient education and a coordinated interdisciplinary team approach. a. 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. What support do you have or wish you had? Twenty‐seven percent still had edema at discharge. Evidence‐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). Kripalani et al reviewed the literature for suggested methods of promoting effective transitions of care at discharge, and their results are consistent with those summarized in our discharge checklist. 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. Patient education a. Address for correspondence and reprint requests: Christine Soong, MD, Division of General Internal Medicine, Mount Sinai Hospital, 600 University Ave, Room 428, Toronto, ON M5G 1X5 Canada; Telephone: 416–586‐4800; Fax: 647-776‐3148; E‐mail: [email protected]. Hospital to identify staff to be involved in meeting, for example the nurse, doctor, patient advocate, discharge planner, or a combination. The checklist was created using recommended human‐factors engineering concepts. 3. Readmissions reduction program, Ontario Ministry of Health and Long‐Term Care. 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. Continue reading →, Your email address will not be published. The panel was composed of expert members from multiple disciplines and across several healthcare sectors, including PCPs, hospitalists, rehabilitation clinicians, nurses, researchers, pharmacists, academics, and hospital administrators. Standardizing discharge planning and initiating processes early on in a patient's hospital stay may ensure a safe transition home. Journal of Hospital Medicine 2013;8:444–449. NOTE: Abbreviations: BPMH, best possible medication history; ED, emergency department; LTC, long‐term care, PCP, primary care physician. Get ready for your hospital stay with this packing list. There is a similar focus on readmission rates in the province of Ontario. [29, 30]Postdischarge care plays an important role in supporting the patient upon discharge and when part of a multifaceted discharge plan can result in decreased readmission rates and hospital utilization. Example outcome measures, if feasible, include Care Transitions Measure (CTM) scores, patient satisfaction surveys, and readmission rates.Several limitations of this study should be considered. Often, transfer of important information and medication review take place only hours before a patient leaves the hospital, a suboptimal time for patient education. 2004;52(7):1228], The care transitions intervention: results of a randomized controlled trial, Project BOOST: Better Outcomes by Optimizing Safe Transitions, Avoiding Hospital Admissions: Lessons From Evidence and Experience, How‐To Guide: Creating an Ideal Transition Home, Medication Reconciliation in Acute Care: Getting Started Kit, US Agency for Healthcare Research and Quality. Although education starting on day 1 of admission may seem premature, we felt there was merit in addressing issues early. a. If necessary, arrange outpatient investigations (laboratory, radiology, etc.). Teach patient how to properly use discharge medications and how these relate to the medications patient was taking prior to admission. The next step of this project is to pilot checklist use through small‐scale Plan‐Do‐Study‐Act (PDSA) cycles followed by large‐scale implementation. c. If necessary, schedule postdischarge care. As well, our paper follows an explicit and defined consensus process. Talk to a social worker or your health plan if you have questions about what your insurance will cover and how much you will have to pay. Posted on: November 5, 2018. The goal of this exercise was to ensure that elements necessary for a successful discharge were viewed through the perspectives of interprofessional groups involved in the care of a patient. ISSN 1553-5606, Toronto Central Community Care Access Centre, Toronto, Ontario, Canada, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada, Quality Healthcare Network, Toronto, Ontario, Canada, Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada, Department of Family and Community Medicine, University of Toronto, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada, Ontario Public Service, Toronto, Ontario, Canada, Division of General Internal Medicine, University of Toronto, Institute of Health Policy Management & Evaluation, University of Toronto, Institute for Clinical Evaluative Sciences, Department of Medicine, University of Toronto and Mount Sinai Hospital, Toronto, Canada, Checklist of Safe Discharge Practices for Hospital Patients, The incidence and severity of adverse events affecting patients after discharge from the hospital, Patient safety concerns arising from test results that return after hospital discharge, Deficits in communication and information transfer between hospital‐based and primary care physicians: implications for patient safety and continuity of care, “I wish I had seen this test result earlier!”: dissatisfaction with test result management systems in primary care, Lost in transition: challenges and opportunities for improving the quality of transitional care, Continuity of care and patient outcomes after hospital discharge, A reengineered hospital discharge program to decrease rehospitalization: a randomized trial, A Quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes, Reduction of 30‐day postdischarge hospital readmission or emergency department (ED) visit rates in high‐risk elderly medical patients through delivery of a targeted care bundle, Interventions to reduce 30‐day rehospitalization: a systematic review, Centers for Medicare and Medicaid Services. c. Thoroughly explain discharge summary to patient (use teach‐back if needed). b. During your stay, your doctor and the staff will work with you to plan for your discharge. The checklist domains include (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.CONCLUSIONSThe Checklist of Safe Discharge Practices for Hospital Patients summarizes the sequence of events that need to be completed throughout a typical hospitalization. An improvement consultant (N.Z.) [17] Available toolkit resources including those developed by the Commonwealth Fund in partnership with the Institute for Healthcare Improvement,[18] the World Health Organization,[19] and the Safer Healthcare Now! c. If necessary, schedule postdischarge care. a.Perform postdischarge follow‐up phone call to patient (for patients with high LACE scores. The instructor then repeats the process until the patient demonstrates correct recall and comprehension. c. Thoroughly explain discharge summary to patient (use teach‐back if needed). Example outcome measures, if feasible, include Care Transitions Measure (CTM) scores, patient satisfaction surveys, and readmission rates. Do I know when my follow-up appointments are? In addition, this checklist was designed to integrate discharge planning into interprofessional care rounds occurring throughout a hospital admission. The group avoided specific detailed recommendations to allow each institution to locally tailor appropriate process and outcome measures to assess fidelity of each component of the checklist.DISCUSSIONA standardized, evidence‐based discharge process is critical to safe transitions for the hospitalized patient. As well, our paper follows an explicit and defined consensus process. [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. Remind patient of upcoming appointments. This is called a discharge plan. Home Care. Download the checklist here. The national average of HF readmission rate was 24.6%. 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. Ask where you will get care after discharge. [21]The discharge process occurring during a patient's hospitalization is a complex, multifaceted care‐coordination plan that must begin on the first day of admission. The checklist domains include (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. You can take this checklist with you, and share it … http://www.who.int/patientsafety/implementation/solutions/high5s/en/inde... http://www.psnet.ahrq.gov/primer.aspx?primerID=14, Choosing Wisely: Things We Do For No Reason. The transition from hospital to home can expose patients to adverse events during the postdischarge period. The goal of this exercise was to ensure that elements necessary for a successful discharge were viewed through the perspectives of interprofessional groups involved in the care of a patient. 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