Handout summarizes discharge instructions
Information is in easy-to-read format
When patients are being discharged from University of Utah Health Care, they receive a one-page handout that supplements the written discharge instructions and gives patients, in an easy-to-read format, all the information they need when they get home.
Stephanie Wallace, RN, manager of care management for University of Utah Health Care, developed the sheet when she was the organization’s transition navigator.
"We are discharging patients today with a higher acuity level than ever before. Patients are still sick when they are being hospitalized and often, they don’t remember everything they are told and may not feel like reviewing a lengthy set of instructions when they go home," she says.
The sheet includes the name and phone number of their primary care provider, the name and number of the care managers at the clinic, and the transition navigator’s name and number.
Information about the discharge diagnosis is written in lay terms and includes a list of things that the patients can expect when they go home. For instance, for pneumonia patients, one item on the list states, "You still will have some coughing."
There is a list of what symptoms indicate that the patient should call the physician office, and a list of reasons to call 911 or go to the emergency department.
"When patients have complex conditions and multiple comorbidities and/or have a low level of health literacy, it’s challenging to educate them on when to call the doctor and when to go to the emergency department. We try to teach them that they are not going to feel 100% right away and educate them on appropriate use of the emergency department," she says.
The handout includes information on the patient’s follow-up appointments, including the address and phone number. The navigator can either schedule follow-up appointments with community clinics via computer or call specialty clinics from the patient room, preferably when the person caring for the patient after discharge is present. Sometimes, the navigator lets the patient talk to the clinic directly.
"When I first started as navigator, we left it up to the patient to make the follow-up appointment, but in some cases, once they start feeling better, they don’t think they need to see their doctor," she says.
The sheet includes information on why a follow-up visit is important, Wallace says. For instance, if the patient has pneumonia, the sheet would state that it’s important to make sure the pneumonia is resolved and the best way to determine that is a face-to-face visit.
The back of the sheet includes all the medication the patient is being discharged with, the last time it was given, and the next time it is due so patients know when to take their medication after they go home, she says.
"Coordinating the medication information is the most challenging part because the physician, the case manager, the discharge nurse and the person transporting the patient home all have to be on the same page about when the last dose is given and when the patient will leave the hospital," Wallace says.
In addition to the proper name of the drug, the sheet includes what the patient calls the drug, such as "heart pill" or "pill for sugar."
"We try to keep things as simple as possible so, instead of being overwhelmed with pages of information, patients have everything they need to know in an easy-to-read format," Wallace says.