OBJECTIVE: To improve stroke patient discharge safety. BACKGROUND: The cerebrovascular service patient's discharge summary is a crucial document for all stroke center hospitals and it facilitates the communication of key changes in patient care with primary care physicians. Stroke patients are given new medical diagnoses during their admissions, and they often have critical medication changes at discharge, such as new anticoagulant, antihypertensive, or diabetic medications. The aim of this project was to develop a standardized and systematic checklist that may help ensure better patient education, follow up, documentation, and improve the medication reconciliation. DESIGN/METHODS: A resident-driven quality improvement project designed a checklist used during cerebrovascular service rounds for each patient planning to be discharged that day. Items on the checklist focused on stroke risk factor modification goals, follow up clinical appointments and studies, patient education, and medication changes. Records were reviewed from the three months prior to the initiation of the project to determine how often discharge documents had to be modified and how often prescriptions were incorrectly provided. This data was compared to the data compiled after implementation of the Stroke Discharge Checklist, which is ongoing to three months afterwards. A survey was administered to residents and attendings before and after execution to obtain perspectives on patient discharges. RESULTS: Preliminary results found that residents and attendings felt the post-discharge safety increased and errors in discharge documentation and discharge prescriptions decreased with use of a checklist. Residents believed they were more prepared for patient discharges when applying the checklist. Ongoing data collection also suggests fewer errors, though the study will continue for a total of three months. CONCLUSIONS: This study serves as an example of how checklists used in medicine can improve patient safety. Furthermore, resident-driven quality improvement projects may serve to better patient care.
Disclosure: Dr. Daniello has nothing to disclose. Dr. Rayhill has nothing to disclose. Dr. Busza has nothing to disclose. Dr. Clark has nothing to disclose. Dr. Otis has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P2.127?rss=1
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