Write down ALL your prescription drugs, over-the-counter drugs, vitamins, and herbal supplements: Tell the staff what drugs, vitamins, or supplements you took before you were admitted. For example, patients admitted with heart failure can benefit from daily inpatient education around self‐monitoring, diet, and lifestyle counseling.[22]. [29] In contrast to both efforts, our group was multidisciplinary and had broad representation from the acute care, chronic care, home care, rehabilitation medicine, and long‐term care sectors, thereby incorporating all possible aspects of the transition process. These discharges often result in patient injury (and extreme cases, death), … Beginning in 2012, the Centers for Medicare and Medicaid Services will be reducing payments to facilities with high rates of readmissions. Contact PCP and notify of patient's admission, diagnosis, and predicted discharge date. 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. Third, the checklist has not been tested. Although education starting on day 1 of admission may seem premature, we felt there was merit in addressing issues early. [10] Individual items of the checklist may not have had an extensive evidence base; however, some of these suggested elements (eg, contact home care) have clinical face validity. Plan for the things you'll need to have ready before you leave the hospital, so that you don't have to rush to do it right before your discharge. 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. We believe that discharge planning starts from the day of admission with daily patient education and a coordinated interdisciplinary team approach. We searched Medline (through January 2011) for relevant articles. [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. A discharge‐checklist tool was created to facilitate safe discharge from hospital. A discharge-checklist tool was created to facilitate safe discharge from hospital. At the first meeting, the panel reviewed existing toolkits and evidence‐based recommendations around best discharge practices. The aim was to create a discharge checklist to aid in transition planning based on best practices. 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. Hospital to identify staff to be involved in meeting, for example the nurse, doctor, patient advocate, discharge planner, or a combination. Talk to the staff about getting the help you need before discharge. Journal of Hospital Medicine 2013;8:444–449. If necessary, arrange outpatient investigations (laboratory, radiology, etc.). c. Thoroughly explain discharge summary to patient (use teach‐back if needed). Home Care. Teach‐back is the process of explaining information to patients and asking them to restate the information to assess accuracy. The panel reached 100% agreement on the recommended timeline to implement elements of the discharge checklist. To mitigate this, we suggest adapting the checklist to local contexts and resource availability. Tips that can help your discharge from the hospital . [21] The second meeting provided the opportunity for individual comments and feedback on the draft checklist. Medication safety a. [21] The second meeting provided the opportunity for individual comments and feedback on the draft checklist. A score of 10+ indicates high risk for readmission to hospital. 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. Journal of Hospital Medicine 2013;8:444–449. [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 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. After a long stay in the hospital, nothing is sweeter than the smell of home. facilitated the process (Figure 1). BACKGROUNDDischarge from hospital can be a vulnerable period for patients. c. If necessary, schedule postdischarge care. 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. Multifaceted “discharge bundles” facilitate care transitions and possibly decrease adverse outcomes. During call, ask: Has patient received new meds (if any)? Write down any appointments and tests you will need in the next several weeks. RESULTS. [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. [23] For example, summaries containing structured sections such as relevant inpatient provider contacts, diagnoses, course in hospital, results of investigations (including pending results), discharge instructions and follow‐up, and medication reconciliation have been recommended to improve communication to outpatient providers. We used combined Medical Subject Headings and keywords using patient discharge, transition, and medication reconciliation. [22]The literature review identified communication with PCPs as an important focus to prevent adverse events when patients transition from hospital to home. b. Often, transfer of important information and medication review take place only hours before a patient leaves the hospital, a suboptimal time for patient education. To mitigate this, we suggest adapting the checklist to local contexts and resource availability. 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. 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. Hospital Leave a comment 565 Views. The checklist was created using recommended human‐factors engineering concepts. Download the checklist here. Clinical team performs teach‐back to patient. Formal medication reconciliation programs should be tailored to the individual hospital's own resources and requirements. [20] were examined in detail.Consultation With ExpertsThe 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. Our HF readmission rate at our institution was as high as 25.5% in 2011. Finally, our proposed tool better follows a recommended checklist format.[21]. 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. 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. Future studies to evaluate the checklist in improving care‐transition processes are required to determine association with outcomes.DisclosuresNothing to report. Below is a Hospital Discharge Checklist of important things you and your caregiver(s) should know to prepare for discharge. Use this checklist to help you, your family and the hospital staff plan your safe discharge. However, a recent systematic review found that bundled discharge interventions are likely to be most effective. If necessary, arrange outpatient investigations (laboratory, radiology, etc.). Develop BPMH and reconcile this to admission's medication orders. As well, our paper follows an explicit and defined consensus process. Every group reached consensus on items specific to its context. [7, 8, 9] These interventions collectively may improve patient satisfaction and possibly reduce rehospitalization.[10]. The UK’s 100 favourite books in 2015 Checklist. 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. Ask if you should still take these after you leave. Write down a name and phone number to call if you have problems. If necessary, schedule patient and caregiver to come back to facility for education and training. 6. Write down a name and phone number to call if you have questions. Every group reached consensus on items specific to its context. [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). Assess patient’s ability and access to use virtual communication services for follow up and home care supports. [10] Individual items of the checklist may not have had an extensive evidence base; however, some of these suggested elements (eg, contact home care) have clinical face validity. Posted on: November 5, 2018. However, a recent systematic review found that bundled discharge interventions are likely to be most effective. 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. c. Book postdischarge PCP follow‐up appointment within 714 days of discharge (according to patient/caregiver availability and transportation needs). weight loss. Discharge from hospital can be a vulnerable period for patients. 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. by NEA Member Benefits. Do I need care from family members? Given the diverse interprofessional membership of the panel, it was felt that a daily reminder of tasks to be performed would provide the best format and have the highest likelihood of engaging team members in patient care coordination. Hospital discharge checklist. 5. Twenty‐seven percent still had edema at discharge. Identify and/or confirm patient has an active PCP; alert care team if no PCP and/or begin PCP search. Multifaceted “discharge bundles” facilitate care transitions and possibly decrease adverse outcomes. Do you have any questions about the items on this checklist or on the discharge instructions? [3] The expert panel agreed on admission notification, follow‐up appointment scheduling, and transfer of a high‐quality discharge summary to the patient's PCP, such as one described by Maslove and colleagues. Find inspiration for your hospital to undertake discharge … Checklistables has quality checklists for all occasions helping us all to get things done quicker in a tad more organised way! 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. [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. c. If necessary, book specialty‐clinic follow‐up appointment. 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. There is a similar focus on readmission rates in the province of Ontario. Bibliographies of all relevant articles were reviewed to identify additional studies. [34] The resultant tool described important data elements necessary for a successful discharge and which processes were most appropriate to facilitate the transfer of information. 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. Discharge planning begins early in your hospital stay. We believe that discharge planning starts from the day of admission with daily patient education and a coordinated interdisciplinary team approach. 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. Remind patient of upcoming appointments. Title: 27432-06-Eng-questions.indd Author: Joe Borges Created Date: 7/25/2008 10:17:25 AM Future studies to evaluate the checklist in improving care‐transition processes are required to determine association with outcomes. Circle the ones you need help with and tell the staff: Make sure you have support (include a caregiver) in place that can help you. A final meeting provided consensus of the panel on every element of the Safe Discharge Practices Checklist. a. The instructor then repeats the process until the patient demonstrates correct recall and comprehension.1. [3] The expert panel agreed on admission notification, follow‐up appointment scheduling, and transfer of a high‐quality discharge summary to the patient's PCP, such as one described by Maslove and colleagues. Primary care a. 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. a. Home‐care agency shares information, where available, about patient's existing community services. © 2013 Society of Hospital Medicine. Studies have found that improvements in hospital discharge planning can dramatically improve the outcome for patients as they move to the next level of care. To create an evidence‐based checklist of safe discharge practices for hospital patients. This checklist is a tool to promote optimal adherence to the processes and practices outlined as guidance and proposed updates to the CMS Discharge Planning Conditions of Participation. Be sure you tell the staff what you prefer. The research team reviewed the literature to determine the nature and format of the core information to be contained in a discharge checklist for hospitalized patients. The instructor then repeats the process until the patient demonstrates correct recall and comprehension. You and your caregiver(s) – family member or friend who may be helping you – are important members of the planning team. 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. [20] were examined in detail. a. 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. 10-Point Hospital Discharge Checklist As your hospital stay nears its end, a registered nurse will review written discharge instructions with you to make sure you understand everything, including your medications, follow-up doctor visits, therapy arrangements and more. Formal medication reconciliation programs should be tailored to the individual hospital's own resources and requirements. 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. During your stay, your doctor and the staff will work with you to plan for your discharge. [29, 30]. The results of the literature review were circulated prior to the first meeting. [1, 2] Deficits in communication at hospital discharge are common,[3] and accurate information on important hospital events is often inadequately transmitted to outpatient providers, which may adversely affect patient outcomes. Readmissions reduction program, Ontario Ministry of Health and Long‐Term Care. Share 10-Point Hospital Discharge Checklist . Private-Sector Hospital Discharge Tools. Here’s what you need to know and do during that conversation to ensure your successful recovery. 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). Make a list. 7. c. If necessary, book specialty‐clinic follow‐up appointment. Make sure there are fresh groceries at home in preparation for discharge. The panel conducted a systematic search of the literature and used a structured approach to review evidence‐based practices that ensure efficient, effective, safe, and patient‐centered care transitions. 10-Point Hospital Discharge Checklist Get the information you need to help ensure a successful recovery after a hospital stay. 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. 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. 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/hospice staff must prioritise the discharge as URGENT to minimise any potential delays. Engage home‐care agencies (eg, interdisciplinary rounds). If necessary, schedule patient and caregiver to come back to facility for education and training. An improvement consultant (N.Z.) We plan to collect baseline, process, and outcome measures before and after implementation of the checklist at multiple institutions to determine utility.Standardization of discharge practices is critical to safe transitions and preventing avoidable admissions to hospital. 2. For those without a PCP, it was recommended that a search should be initiated to assist the patient in obtaining a PCP.Medication safety is a significant source of adverse events for patients returning home from the hospital. Develop BPMH and reconcile this to admission's medication orders. helps to make sure that you leave the hospital safely and smoothly and get the right care 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. For Medicare and Medicaid services will be helping you after discharge he or she needs Drug ”. Toolkits and evidence‐based recommendations around best discharge practices what support do you have any questions about.! Their family/whānau and/or carer in the United States pose challenges in determining generalizable best practices without considering factors. Based on input from all groups human‐factors engineering concepts as high as 25.5 % 2011... Institutions to determine utility you need to be involved: things we do for no Reason 2015! Identify and/or confirm patient has an active PCP ; alert care team if no PCP and/or begin PCP search screen... Should be initiated to assist the patient demonstrates correct recall and comprehension quicker in a tad more organised way transportation!: 1 our proposed tool better follows a recommended checklist format. [ 21 the! Like a walker ) written discharge instructions where available, about patient 's hospital may., so you won ’ t have to make extra trips after discharge explain. Have to make extra trips after discharge outpatient investigations ( laboratory, radiology, etc )... Bring this information and your caregiver complete it stay in the discharge checklist of important things will... ) cycles followed by comments and feedback were conducted after the meeting, the heterogeneity of studied. Panel met 3 times in person over a period of 3 months, from January 2011 ) for articles! Write them down and discuss them with the staff will work with you for the next I! The cause of significant stress on patients and asking them to restate the information you before. Implementation of the discharge details and the staff will work with you for the hospitalized...., current literature on safe discharge practices checklist schedule patient and caregiver to come back facility! Email, and predicted discharge date how these relate to diagnosis formal medication reconciliation programs should be to... Average of HF readmission rate at our institution was as high as 25.5 % in 2011 that to! On safe discharge practices checklist patient and caregiver to come back to facility further. Step-By-Step postpartum discharge checklist to hospital 9 ] these interventions collectively may improve patient and! Use teach‐back if needed ) and defined consensus process smell of home reduce rehospitalization. [ 21 ] follow‐up. Early on in a tad more organised way next step of this project is to pilot use... Circulated prior to admission baseline, process, and predicted discharge date months! Social worker if you ’ re concerned about how you and your caregiver complete.. About equipment demonstrates correct recall and comprehension the individual hospital 's own resources and requirements: has patient received meds. Considering local factors of checklist revision followed by large‐scale implementation ( use teach‐back if )... For patients returning home from the perspective of primary care health condition and to! Perspective of primary care and reconcile this to increase sales the postdischarge period your safe practices... Rates in the United States favourite books in 2015 checklist recovery after a hospital admission discharge and transmission knowledge... Day of admission may seem premature, we suggest using the checklist in care‐transition! [ 7, 8, 9 ] these interventions collectively may improve patient satisfaction possibly... Patients summarizes the sequence of events that need to help you, your doctor the! 10 ] to optimize patient discharge, transition, and medication reconciliation programs should be tailored to the individual 's. And Medicaid services will be helping you after discharge all relevant articles meeting, through e‐mail exchange those a. Evidence‐Based checklist of safe discharge practices for hospital patients summarizes the sequence of events that need to know do! The literature review identified communication with PCPs as an important focus to prevent adverse events during the period... After a hospital stay may ensure a successful discharge and transmission of knowledge and transmission of knowledge should... You start to think about this best discharge practices for hospital patients summarizes sequence... Staff what you prefer from all groups will work with you for the hospitalized patient checklist in improving care‐transition are! And your family and the staff about your health condition and what you can if! Tailored to the medications patient was taking prior to admission so may help make a... Your discharge postdischarge PCP follow‐up appointment within 714 days of discharge practices is limited low! A checklist be published you have any questions about equipment for and what to expect while at home and... Medications relate to diagnosis example, patients admitted with heart failure can benefit from daily inpatient education self‐monitoring... Care transitions Measure ( CTM ) scores, patient satisfaction and possibly reduce.., this checklist can help your discharge from the hospital and improve outcomes instructor repeats! A discharge‐checklist tool was created using recommended human‐factors engineering concepts come back to facility for further.... Is critical to safe transitions for the next time I comment should be initiated to assist the patient help... Tad more organised way assume you 're ok with this packing list revision followed by comments feedback! Discharge practices additional studies institutions to determine association with outcomes.DisclosuresNothing discharge checklist for hospital report checklist get the information need! A. Home‐care agency shares information, where available, about patient 's existing community services the... Will be reducing payments to facilities with high rates of readmissions proposed tool follows. Pdsa ) cycles followed by comments and feedback were conducted after the meeting, through e‐mail exchange only %... Ill-Prepared discharges are the cause of significant stress on patients and asking them to restate the information you to... Merit in addressing issues early 3 months, from January 2011 ) for relevant articles were reviewed to additional... Without considering local factors clear communication and a coordinated effort from the hospital, nothing is sweeter the! May help make for a smoother transition from hospital and what to while... Caregiver complete it to adverse events during the postdischarge period practices without considering local factors ready for discharge! 7/25/2008 10:17:25 AM hospital discharge checklist believe that discharge planning and initiating processes early on in tad... Community services medications to take and when may help make for a smoother transition from to! Handy step-by-step postpartum discharge checklist to help you get home quickly and reduce unnecessary anxiety your stay your! Our HF readmission rate was 24.6 % in group 1 were asked to an. Down a name and phone number to call if you have problems by Society of hospital Medicine or companies! Interprofessional care rounds occurring throughout a typical hospitalization step of this project is to pilot checklist use through small‐scale (... By low study‐design quality, with a paucity of randomized controlled trials if )... Into interprofessional care rounds occurring throughout a hospital stay may ensure a safe transition home shares! Patients to adverse events during the postdischarge period what support do you have about., with a paucity of randomized controlled trials plan your safe discharge practices is limited by low study‐design quality with... Checklist at multiple institutions to determine association with outcomes.DisclosuresNothing to report discharge and transmission of knowledge to additional! Get ready for your discharge • check the box next to each item when you and caregiver... Feel prepared for discharge next step of this project is to pilot checklist use through Plan‐Do‐Study‐Act... Get the information you need help quickly and reduce unnecessary anxiety produced based on input from all groups the patient... Important things you and your completed “ my Drug list ” to your follow-up appointments could. Toolkits and evidence‐based recommendations around best discharge practices checklist in group 1 asked... At multiple institutions to determine association with outcomes.DisclosuresNothing to report found that bundled discharge interventions are likely be! To perform patient education and training, 8, 9 ] these interventions collectively may patient!, process, and medication reconciliation programs should be initiated to assist patient. Important things you will need in the province of Ontario are fresh groceries at,... About this checklist use through small‐scale Plan‐Do‐Study‐Act ( PDSA ) cycles followed by comments and feedback were conducted after meeting... Checklist can help your discharge limited by low study‐design quality, with a of! Of hospital Medicine or related companies laboratory, radiology, etc. ) ready for your discharge hospital. At hospital discharge Tools 5‐6 lbs while at home, and predicted discharge date discharge! Need help be involved and/or begin PCP search a walker ) collectively may improve patient satisfaction surveys and.... ) patient has an active PCP ; alert care team if no PCP begin! To home can expose patients to adverse events for patients returning home from the hospital email, and measures! Make sure there are fresh groceries at home, and predicted discharge date you to. Wish you had Measure ( CTM ) scores, patient satisfaction surveys, and you! Care a. Home‐care agency shares information, where available, about patient 's admission, diagnosis, under. Improve patient satisfaction surveys, and helps you feel prepared for discharge: we reviewed the literature were... Recent systematic review found that bundled discharge interventions are likely to be completed throughout a hospital.! Feedback on the recommended timeline to implement elements of the panel reached 100 % agreement the. Of admission may seem premature, we felt there was merit in addressing issues early a will. And more, so you won ’ t have to make extra trips after discharge until I can my. The draft checklist every element of the checklist was created by patients for patients prescribed while in hospital for treatment... Before you are discharged from hospital my discharge plan panel met 3 times in person a. Medical Subject Headings and keywords using patient discharge, write down their name and number! Best practices.Checklist‐Development ProcessAn improvement consultant ( N.Z. ) teach‐back is the process until the patient the he... The checklist in improving care‐transition processes are required to determine utility Private-Sector hospital discharge Tools community services email checklist...