Discharge Checklist Shows Results for Cleveland Clinic
A new discharge checklist, developed by a multidisciplinary team at Cleveland Clinic, has improved rates for medication reconciliation and completion of discharge summaries at the provider’s main campus, according to HealthLeaders.
Improving patient safety was a motivator in creating a more efficient discharge process. “There can be medication errors, side effects, and confusion after a discharge if we don’t get it right,” said Amy O’Linn, DO, hospitalist and physician lead for enterprise readmission reduction at Cleveland Clinic, in the HealthLeaders article.
The checklist includes a medication reconciliation document, which is a mandatory step in the discharge process, and a discharge summary. After the new checklist was implemented, the completion rate for medication reconciliation increased from 88 percent to 98.7 percent, and the completion rate for discharge summaries saw a dramatic increase from 58 percent to 80 percent. While the discharge summary is not mandatory, clinicians are encouraged to address key questions about the patient’s hospital stay and care, covered by 18 different elements in the document.
“What we are encouraging providers to do is answer key questions: What brought the patient to the hospital? What happened during the hospital stay? And what is the plan going forward? The 18 elements that are part of our policy are not as useful in detailing the story of a hospital stay. The story is where the money is—it’s what happened and what’s going to happen now,” O’Linn told HealthLeaders.
The discharge checklist was incorporated into Cleveland Clinic’s electronic health record system, which O’Linn notes as a key step in its success along with support from C-suite representatives in the organization. “The culture change needs to come from the top. The administration needs to say, ‘We are going to protect the patient,’” said O’Linn to HealthLeaders.
The Ohio Patient Safety Institute recognized Cleveland Clinic’s work creating and implementing the new discharge checklist with the Acute Care Best Practice Award in March.
Sarah Sheber is assistant editor/web editor at Journal of AHIMA.