Development of a checklist of safe discharge practices for hospital patients.

BACKGROUND Discharge from hospital can be a vulnerable period for patients. Multifaceted "discharge bundles" facilitate care transitions and possibly decrease adverse outcomes. We describe a structured approach to discharge planning, starting from admission and proceeding through discharge, using a standardized checklist of tasks to be performed for each hospitalization day. OBJECTIVE To create an evidence-based checklist of safe discharge practices for hospital patients. METHODS In the province of Ontario, the Ministry of Health and Long-Term Care convened a panel of expert members from multiple disciplines and across several healthcare sectors. 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. A discharge-checklist tool was created to facilitate safe discharge from hospital. RESULTS 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. 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. CONCLUSIONS The Checklist of Safe Discharge Practices for Hospital Patients summarizes the sequence of events that need to be completed throughout a typical hospitalization. Standardizing discharge planning and initiating processes early on in a patient's hospital stay may ensure a safe transition home.