DischargeChecklist and Document Envelope Work Flow

Action / Staff Responsible / Steps / Considerations/Additional Information
Receive notice of discharge. / Care Management Assistant (CMA) / Establish communication routine for/with unit staff according to unit culture and unit Care Rounds schedule. / Discharge communication sources: Provider order sheet, primary nurse (or her/his team nurse), RN/SW Care Manager
Verify the discharge or transfer order. / CMA / Confirm presence of a discharge order in the medical record/CPOE. / MN law requires the attending provider (MD, NP, CNS, PA)write adischarge or transfer orders.
Obtain the DischargeEnvelope. / CMA / Keep a supply of the Discharge Transfer Envelopes on handat the CMA desk and/or the unit work station (HUC/IC desk).
Order regularly from stores.
Place a patient label on the Discharge and TransferEnvelope. / Current paper process requires a large manila envelope for documents.
Near future plan is for an electronic process for “Discharge and Transfer” documents.
Compile/facilitate elements needed for the Discharge Checklist and Discharge Envelope as appropriate. / CMA / Compile the list of elements on the Discharge Checklist.
Place elements in the Discharge Envelope, fax documents as appropriate.
Give the Discharge Envelope to the HUC/IC. / HIPPA requires confidential handling of all patient records including discharge documents. See the HealthEast HIPPA policy.
Receive notice of discharge. / Hospital Unit Coordinator (HUC)/Information Coordinator (IC) / Establish communication routine for/with unit staff according to unit culture and unit Care Rounds schedule. / Discharge communication sources: Provider order sheet, primary nurse (or her/his team nurse), RN/SW Care Manager
Obtain a Discharge Checklist form. / HUC/IC / Keep a supply of the Discharge Checklist forms on handat the unit workstation (HUC/IC desk)/CPOE.
Place a patient label on the Discharge Checklist form.
Place the Discharge Checklist on the Discharge Document Envelope.
Retain a copy of the signed Discharge Checklist as part of the permanent medical record. / HIPPA requires confidential handling of all patient records including discharge documents. See the HealthEast HIPPA policy.
Review the Discharge Checklist / HUC/IC / Assess presence of the elements listed on the Discharge Checklist.
Mark Discharge Checklist in the completed column for each element present with initials, the date and time in the completed field of all elements on the Discharge Checklist.
Review the Discharge Checklist hourly until completed to assure all elements are present by the time of discharge or transfer. / Initially a limited number of facilities will have access to the Portal. Most facilities will have access in the near future.
Once a facility has access to the Physician Portal, documents will also be available electronically.
Initialing, dating and timing of the missing element field will provide accountability and assist with identification/tracking of work flow patterns and educational needs.
Notify the unit RN Care Manager if/when there is a missing element of the Discharge Checklist. / HUC/IC / Inform the unit’s RN Care Manager of the missing element(s) on the Discharge Checklist. Assure there are initials, date, time in the completed field of all elements on the Discharge Checklist. / The RN Care Manager is responsible for overseeing the discharge process and providing any missing elements of the Discharge Checklist.
Initialing, dating and timing of the missing element field will provide accountability and assist with identification/tracking of workflow patterns and educational needs.
Re-review the Discharge Checklist. / HUC/IC / Confirm the RN Care Manager has provided the missing element information from the Discharge Checklist and updated the form by placing her/his initials, the date and time in the missing element field. / Initialing, dating and timing of the missing element field will assist with identification/tracking of workflow patterns and educational needs.
Initialing, dating and timing of the missing element field will provide accountability and assist with identification/tracking of work flow patterns and educational needs.
Arrange for follow up services as ordered. / HUC/IC / Arrange for appointments as ordered: tests, therapy, primary and specialty care provider appointments. / Readmissions often occur before the patient is seen by a provider post the admission. Having an appointment made before the patient leaves the hospital will help decrease unnecessary Emergency Room visits and unnecessary hospital admissions by connecting the patient and family to the primary care and/or the specialty care provider post hospitalization.
Complete assigned or delegated tasks as appropriate. / HUC/IC / Assist with discharge or transfer information exchange and coordination of services as requested by nursing, care management or provider (attending MD, hospitalist, NP, CNS, PA). / This is part of two of our HealthEast Core Behaviors:
Patient Centered – Provide services centered on the needs and safety of our patients and their families and
Compassionate Service – Exceed customer’s expectations through service excellence.

Page 1 of 4Discharge Checklist and Document Envelope Work Flow Created 9.9.10, updated 11.23.10