Hospital discharge checklist for families in Placer County

Discharges happen fast, often with a few hours' notice, and the instructions come on a stack of paper handed to a tired patient. This checklist is what we walk families through when they call us before a discharge from Sutter Roseville, Kaiser Roseville or Sutter Auburn Faith.

Before discharge: questions for the case manager

• What is the exact discharge date and time, and who is providing transportation?
• Has home health been ordered? Which agency, and when is the first visit?
• What equipment is being delivered (walker, commode, shower chair, hospital bed) and when?
• Which medications are new, which are stopped, and where are the prescriptions being sent?
• What are the activity restrictions, weight-bearing limits and diet instructions?
• When are the follow-up appointments, and are they already scheduled?
• What symptoms should trigger a call to the doctor or a return to the ER?

At home before the ride back

• Set up a bedroom on the ground floor if stairs are involved.
• Clear the path from the front door to the bed to the bathroom. Remove rugs and cords.
• Put a lamp, water, phone and charger within reach of the bed.
• Stock the kitchen with foods that match the diet instructions.
• Confirm the pharmacy has the new prescriptions ready, or plan the stop on the way home.
• Install a night light between bedroom and bathroom.

The first 72 hours

• Someone should be in the home overnight the first two or three nights. Falls cluster in the first 48 hours.
• Write out the medication schedule on paper and check it off. Do not rely on memory or the discharge summary alone.
• Push fluids. Dehydration is one of the most common reasons for readmission.
• Watch for confusion, fever, shortness of breath, swelling, or a wound that looks worse.
• Confirm the home health nurse's first visit and the follow-up appointment dates.

Where home care fits

If nobody in the family can be there for the first days, or the person who can is 82 and recovering from their own surgery, that is what post-hospital care is for. We can often start on discharge day, handle the pharmacy stop, and provide overnight coverage until the recovery is stable. Call us as soon as you know the date.