BACKGROUND AND OBJECTIVE:
Adverse events related to peridischarge management can result in serious harm and inconvenience to patients. The rate of adverse events can be reduced by enhancing the partnership between the medical team and patients through patient education. By introducing a new streamlined and comprehensive discharge checklist, we aimed to improve patient education with regard to peridischarge issues, thereby reducing the occurrence of serious reportable events related to peridischarge management.
The new discharge checklist was added to the cover page of the clerical notes in August 2013 (with patient diagnoses, discharge medications, and follow-up plans). The checklist includes patient education on discharge medications, external devices, wound care, and return to the hospital. Data on 50 patients per month were collected in July 2013, when the old discharge checklist (separate from the clerical notes and often missing) was in use, and in August to October 2013, when the new checklist was added. We also audited data on reportable hospital occurrences from 2012 and 2013.
Apart from the first month, when residents were adapting to the new checklist, the implementation of the new checklist has improved compliance and reduced the time taken to complete the checklist. Of note, there was a higher rate of completed checklists within a day of discharge. Prompt completion allows timely patient education before discharge. Since the implementation of the discharge checklist, we have had no serious reportable events related to peridischarge events (previously 1 per year in 2012 and 2013 before implementation of checklist). In fact, good patient education has helped parents identify on wrong doses of discharge medications. The rate of reattendance to the children’s emergency department after discharge for a related problem has increased. This increase could be attributed in part to better patient education and empowerment of parents to know when to bring their child back for medical attention.
Our discharge checklist is successful in improving patient education and has empowered patients to seek medical attention early, thus preventing adverse events. The streamlined version has helped improve compliance and reduce time taken to complete the form.
- Copyright © 2015 by the American Academy of Pediatrics