SHM Converge Scientific Abstract ePoster Gallery-Emphasizing Individualized Anticipatory Guidance and Self-Management in Discharge Instructions

Pdf Summary

This quality improvement study examined discharge instructions for internal medicine patients sent home from the hospital. The team found that important elements of anticipatory guidance and self-management were rarely included in standard discharge instructions, even though these details can improve discharge safety and potentially reduce readmissions.<br /><br />To address this, the authors created a new Epic Discharge Instruction SmartPhrase designed to prompt residents to include three key items: how to manage symptoms at home, who to contact with questions, and when to return to the emergency department. The SmartPhrase was refined through five PDSA cycles using chart review data and resident survey feedback.<br /><br />After implementation, discharge instructions containing all three components increased from 0% before the intervention (N=23) to 18% after the intervention (N=90). The SmartPhrase was used in 31% of post-intervention discharges. Most residents—81%—reported that the SmartPhrase added value to discharge instructions.<br /><br />The study concluded that adding a structured prompt improved the inclusion of individualized anticipatory guidance in discharge instructions, but overall use remained limited. The authors recommend future work focused on better integrating the SmartPhrase into clinical workflow to improve adoption.

Asset Subtitle

Jenna Carson

Meta Tag

Author List Jenna Carson, Jessica Donato

Category Research

Concept Discharge Instruction

Concept Anticipatory Guidance

Concept Self-Management

Concept Symptom Management

Concept Discharge Instruction SmartPhrase

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic

Presenting Author Jenna Carson

Track Quality Improvement

Keywords

discharge instructions

internal medicine

anticipatory guidance

self-management

hospital discharge

Epic SmartPhrase

quality improvement

PDSA cycles

resident feedback

readmission prevention

Discharge Instruction

Anticipatory Guidance

Self-Management

Symptom Management

Discharge Instruction SmartPhrase