• Hospital Patient Discharge Process Improvement Checklist

    Use this form to review discharge readiness, education, follow-up needs, and process improvement opportunities for a hospital patient discharge.

  • Discharge Review

  • Discharge Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Discharge Status / Readiness*
  • Core Discharge Steps Completed

  • Medication and Care Instructions

  • Medication reconciliation completed*
  • Discharge medications reviewed with patient or caregiver*
  • Follow-up instructions explained*
  • Warning signs or red-flag symptoms reviewed*

  • Equipment, Support, and Follow-Up

  • Home medical equipment needed
  • Home health or community support arranged?*
  • Follow-up appointment date and time
     - -
    2 digit month, 2 digit day, 4 digit year
  • Barriers to discharge identified

  • Improvement Checklist and Feedback

  •
  • Patient/caregiver understanding of discharge instructions
  • Should be Empty:
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