IMPROVING

DISCHARGE
COMMUNICATION
BY: ELIANA VELAZQUEZ, RN & YOLANDA ENG, RN
 PROBLEM
PATIENTS ADDRESSED MULTIPLE CONCERNS REGARDING THE DISORGANIZATION OF
DISCHARGE INSTRUCTIONS. THE ADDRESSED CONCERNS WERE IN REGARDS TO FOLLOW-UP
APPOINTMENTS, PRESCRIPTIONS, TESTS, GENERAL INFORMATION AND EDUCATION.
THE SOLUTION WAS TO DEVELOP DISCHARGE TABS (5 DIVIDERS, AVAILABLE IN ENGLISH OR
SPANISH)
1. PRESCRIPTIONS - RECETAS
2.FOLLOW UP APPTS - CONSULTS/CITAS/CONSULTAS
3. LABS/TESTS LABORATORIA/EXAMENES
4. PATIENT EDUCATION - EDUCACION
5. MISC. - MISELANEO
 PICO
P- PATIENT/POPULATION: WOMENS SURGICAL, WEST TOWER 3, & THOMASON TOWER 3
I- INTERVENTION: IMPLEMENT THE USE OF DISCHARGE TABS BY PLACING THE TABS IN
ADMIMISSION FOLDER LOCATED IN PATIENTS ROOM AND ORGANIZING THE DISCHARGE
INSTRUCTIONS BY CATEGORY.
C- COMPARISON: THE USE OF ADMISSION FOLDER ONLY
O- OUTCOME: TO ACHIEVE AN INCREASE IN HOSPITAL CONSUMER ASSESSMENT OF
HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) INPATIENT CORE SURVEY BY NURSING
UNITS SCORES IN THE FOLLOWING AREAS: NURSE COMMUNICATION, COMMUNICATIONS
ABOUT MEDICATIONS, DISCHARGE INFORMATION AND TRANSITION OF CARE
ADMISSION FOLDER & DISCHARGE TABS
 PURPOSE OF THOSE AREAS
NURSE COMMUNICATION:
- CLEAR COMMUNICATION BY NURSES
COMMUNICATION ABOUT MEDICATIONS:
- EXPLANATION OF NEW MEDICINES
- COMMUNICATION OF POSSIBLE SIDE EFFECTS
DISCHARGE INFORMATION:
- TALKING TO PATIENTS ABOUT HELP AFTER DISCHARGE
- PROVIDING WRITTEN DISCHARGE INSTRUCTION
TRANSITION OF CARE:
- TALKING TO PATIENT AND FAMILY REGARDING NEEDS AFTER DISCHARGE
- PATIENT HAD A GOOD UNDERSTANDING OF INSTRUCTIONS
- PATIENT UNDERSTOOD PURPOSE FOR TAKING MEDICATION PRESCRIBED AT
DISCHARGE
 EVIDENCE BASED PROJECT QUESTION

WILL THE USE OF THE DISCHARGE TABS IMPROVE HCAHPS INPATIENT CORE
SURVEY BY NURSING UNITS SCORES IN THE FOLLOWING AREAS: NURSE
COMMUNICATION, COMMUNICATIONS ABOUT MEDICATIONS, DISCHARGE
INFORMATION AND TRANSITION OF CARE?
IMPORTANCE OF EVIDENCE BASED PROJECT
QUESTION
BECAUSE CLEAR COMMUNICATION FROM NURSES TO PATIENTS ALLOW FOR
FULL UNDERSTANDING OF FOLLOW-UP APPOINTMENTS, REFERRAL
INFORMATION INSTRUCTIONS AFTER DISCHARGE AND DIRECTIONS ON HOW
MEDICATION IS TAKEN, THE PURPOSE OF THE MEDICATION, THE DOSE AND
THE SIDE EFFECTS OF THE MEDICATION.
 DATA COLLECTION

OCTOBER 2016 JANUARY 2017: GATHERED AND COMPARED INPATIENT

CORE SURVEY BY NURSING UNITS SCORES IN THE FOLLOWING THREE UNITS;
WSU, WT3 & TT3
FEBRUARY 2017 DISCHARGE COMMUNICATION IMPROVEMENT (DISCHARGE
TABS) IN-SERVICE OF ALL REGISTERED NURSES IN WSU, WT3 & TT3
MARCH 2017 NOW: GATHER AND COMPARE INPATIENT CORE SURVEY BY
NURSING UNITS SCORES IN WSU, WT3 & TT3 UNITS TO DETERMINE IF THE
USE OF DISCHARGE TABS MAKE DISCHARGE INSTRUCTIONS MORE ORGANIZE
AND IN TURN INCREASE THE UNIT SCORES WHILE AVOIDING READMISSIONS
PRE & POST DISCHARGE TAB SCORES
PRE &POST DISCHARGE TAB SCORES
PRE & POST DISCHARGE SCORES
 CONCLUSION

EVEN THOUGH THE USE OF DISCHARGE TABS WAS IMPLEMENTED BY ALL

NURSING STAFF MEMBERS DURING THE DISCHARGE PHASE. THE
CONCLUSION IS THAT THE ORGANIZATION OF THE DISCHARGE IS NOT AS
IMPORTANT AS THE ACTUAL TEACHING. IT IS DIFFICULT TO DISCHARGE A
PATIENT IN A TWO HOUR PERIOD WHEN THE NURSE HAS TO GET THE
DISCHARGE INSTRUCTIONS TOGETHER, THE PRESCRIPTION, THE SUPPLIES,
AND HAVE FIVE TO SIX OTHER PATIENTS NEEDING ASSISTANCE ALL AT THE
SAME TIME. IN OUR OPINION AND BASED ON WHAT WE HAVE EXPERIENCED
IN THE FLOOR, IT WOULD BE IDEAL TO HAVE A DISCHARGE NURSE ON THE
FLOOR AT ALL TIMES.
 REFERENCES

KRYSTAL LOPEZ, RN, BSN, FORMER ASSISTANT NURSE MANAGER, WOMENS

SURGICAL UNIT
CHRISTOPHER MORALES, SUPERVISOR GUEST SERVICES
DAVID G. SMEAD, DIRECTOR, CARE MANAGEMENT