Mills Peninsula’s discharge instructions include each medication the patient is on, when they took it last, and when they should take it next.
The medication section that we included with our discharge instructions went through multiple iterations. We reached a point where every medication was clearly indicated with how often patients should take it, but we realized they didn’t know when to start taking the medications after they were discharged. Do they start the next morning or that night? There were concerns that patients would skip doses or double-dose without realizing it.
Mills Peninsula is a non-profit hospital in Burlingame, CA that has partnered with the Palo Alto Medical Foundation and Peninsula Family Services to develop the Peninsula Circle of Care program. The hospital has 241 beds and serves a primarily elderly population (average age of 81) living alone with 90% on Medicare. Peninsula Circle of Care, their transitions program, began in 2012 and is influenced by the Care Transitions Program and a community based model.
What We Tried
We updated our discharge instructions to include a place to put when the last dose of each medication was given. Now, when nurses review the discharge instructions with patients, they add in when each medication was given and when to take the next dose. The updated discharge instructions are then scanned back into the EHR for future reference.
This was an easy change that made a big difference for our nurses and the patients. The nurses appreciate that there is a standard place to put this information and a reminder to review it with patients at the bedside. The last dosage information also benefits patients because it’s very clear how to transition from hospital to home.