Download METROPOLITAN HOSPITAL CENTER

METROPOLITAN HOSPITAL CENTER
Department of Medicine/Division of Geriatrics
Discharge Summary Template
Make sure your patient is PRIMED for discharge!
Primary diagnosis
-Secondary diagnoses
Return to:
List clinics and appointment times
Name and contact information of PCP
Inpatient hospital course:
Key findings and results
Procedures
Complications
Condition at discharge (including functional and cognitive status)
Medication reconciliation
All medications patient is to take after discharge
New medications and indications
Discontinued medications and why they were discontinued
If prescribing antibiotics, the start and end dates
Exams and Expertise: What needs to be followed after discharge
Labs
Studies
Consult recommendations
Destination and DNR status:
Home versus rehab (include name of facility and contact
information)
Code status and advance directives
Tips on Improving Transitions of Care
READY your patient for discharge!
Referring and Receiving providers:
-Contact providers at the time of admission and give providers a copy of the
discharge summary at the time of discharge
Educate:
-Determine patient and caregiver knowledge about the current medical condition,
medications, and plan of care
-Provide written educational materials in patient’s preferred language and
educational level
-Use teach-back method
Anticipate needs:
-Assess patient and caregiver’s financial and social needs at the time of admission
-Assess patient’s ability to perform activities of daily living at the time of admission
and reassess before discharge
-Make appropriate and timely referrals to consultants, social work, physical therapy,
occupational therapy, and homecare
Discharge summary and Drugs
-Have a complete and accurate discharge summary on the day of discharge
-Reconcile medications:

Have patient’s family bring all medication bottles from home to
review with you

Only provide prescriptions for medications that the patient does not
already have

Review and update the prescriptions on the electronic medical record

Be careful with hospital formularies and brand name medications-do
not let patient get duplicate medications at the time of discharge

Give enough medications to last until patient sees the primary care
provider
Your contact information
-Give patient a phone number to call with questions occurring after discharge
Card developed by Sophie Lin, M.D.