The Discharge Instructions Are the Handoff: Ask for the Written Plan Before the Car Leaves

The discharge instructions are the one piece of paper that tells the home what the hospital expected. They are easy to receive in a rush and hard to rebuild later. Ask for them early in the day of discharge, not in the last ten minutes, and read them before anyone signs the release.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

What the hospital owes you

Federal rules for hospitals require a discharge plan that is started early and that the patient and family take part in, and they require the plan to be documented (42 CFR 482.43, discharge planning, eCFR). That plan is where the written instructions, the follow-up list, and the equipment decisions should come from. If the planner has not met with you, ask for that meeting before you leave.

The four papers to request

Ask for these in writing and keep a copy of each.

The first is the written discharge instructions in plain language. Ask the nurse to walk through them with you and to say which items apply to daily life at home. The team makes the medical decisions; your job is to make sure each item is understood and has an owner.

The second is the follow-up list. For each appointment, write the date and time if one is set, the name of the office, and the person who will book any appointment that is not yet on the calendar. If nobody has been named to book it, ask the discharge planner to name one before you leave.

The third is the equipment order, which lists each item the hospital has ordered for home, the supplier, and the delivery window. Compare the list to what the discharge planner told you. If an item is missing, ask whether it was ordered or still needs to be.

The fourth is the medication list. The family keeps the list, and the doctor and the pharmacist are the ones who answer questions about what each medicine is for and how it is taken. A family member or a hired non-medical caregiver can pick up a prescription as an errand and can give reminders from the list, but the sorting, giving, and managing of medicine stays with the family, the doctor, and the pharmacist.

Read them against each other

Lay the four papers side by side before you leave. Check that the follow-up list matches the instructions, that the equipment list matches what was discussed, and that the medication list matches what the nurse read aloud. If any item does not match, stop and ask the nurse to correct it before the car is loaded. A mismatch that is found at the bedside takes five minutes; one found on the second evening at home takes a phone call that may not be answered.

Ask the questions that show who owns what

Ask who to call in the first two days, and what number to use after hours. Ask what the parent needs help with in the first two days, and whether the team expects a visit or call from home care. Ask whether any item in the instructions needs a person in the house the whole time. Write the answers next to the item they belong to.

Keep the packet together

Put the instructions, the follow-up list, the equipment order, and the medication list in one folder, with the planner's name and direct number on the cover. The sources page on this site lists the references behind the rules mentioned here, so you can check any statement against the original text.