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A Multidisciplinary Discharge Timeout Checklist Improves Patient Education and Captures Discharge Process Errors

Gao, Michael, C., MD; Martin, Paul, B., MD, MPH; Motal, Julius, MS; Gingras, Laura, F., MD; Chai, Christina, MD; Maikoff, Megan, E., MPA, BSN; Sarkisian, Alex, M., MD, MSc; Rosenthal, Nadine, DNP, RN, CCRN, NEA-BC; Eiss, Brian, M., MD

Quality Management in Health Care: April/June 2018 - Volume 27 - Issue 2 - p 63–68
doi: 10.1097/QMH.0000000000000168
Strategies for Quality Improvement

Objective: To design and implement a discharge timeout checklist, and to assess its effects on patients' understanding as well as the potential impact on preventable medical errors surrounding hospital discharges to home.

Methods: Based on the structure successfully used for surgical procedures and using the Model for Improvement framework, we designed a discharge checklist to review and assess patients' understanding of discharge medications, catheters, home care plans, follow-up, symptoms, and who to call with problems after discharge. In parallel, we developed a process of integrating the checklist into the discharge process after routine discharge procedures were completed. We used the checklists to assess patients' level of understanding and need for additional education as well as changes in discharge documentation; we also noted whether good catches of significant errors in the discharge process occurred.

Results: Over 6 months of study, 190 discharge timeouts out of 429 eligible discharges were completed. Additional education was provided in 53 of 190 discharge timeouts (27.8%), with 62% of this education being related to medications. Twenty-one (11.1%) discharge timeouts resulted in at least one change to the discharge documentation or a good catch.

Conclusions: A multidisciplinary discharge timeout directly involving the patient can be effective in targeting additional areas for patient education and in potentially reducing preventable adverse events.

NewYork-Presbyterian Hospital, New York (Drs Gao, Martin, Gingras, Chai, Rosenthal, and Eiss, Mr Motal, and Ms Maikoff); Department of Medicine (Drs Gao, Martin, Gingras, Chai, and Eiss), Division of General Internal Medicine, Section of Hospital Medicine (Drs Gao and Martin), Division of General Internal Medicine, Section of Ambulatory Medicine (Drs Gingras and Eiss), and Division of Geriatrics and Palliative Medicine (Dr Eiss), Weill Cornell Medical College, New York; and Tulane University School of Medicine, New Orleans, Louisiana (Dr Sarkisian).

Correspondence: Paul B. Martin, MD, MPH, Weill Cornell Medicine, Hospital Medicine, 525 E 68th St, Box 331, New York, NY 10065 (pam9126@med.cornell.edu).

The authors report no conflicts of interest.

© 2018Wolters Kluwer Health | Lippincott Williams & Wilkins