Discharge day: the checklist to run before you leave the ward

Discharge starts the day before

The moment anyone says the word "home", start asking questions — not on the morning itself.

Ask the ward three things: when is discharge expected, what has to happen before it can go ahead, and who is coordinating it. The answer to the second one is usually a short list — medicines to come up from the pharmacy, a form to be signed, transport to be arranged, equipment to be delivered — and every item on it is something that can slip.

Ask to be called before your parent is dressed and waiting, not after. Ask for the ward's direct number and write down the name of the discharge coordinator.

Then do the house that night. People are often discharged in whatever they arrived in, which may have been cut off, soaked or thrown away.

• Clean clothes, underwear, and shoes that actually fasten — bring them in a bag
• Heating on, a light left on, milk and bread in, a meal that needs nothing
• A phone and charger within reach of the chair your parent will sit in
• Keys sorted: who has one, who is letting the delivery in, who is calling round
• The route from the car to the front door cleared and lit
• Somebody told: a neighbour, a sibling, whoever is on the contact sheet

Do not leave without these five pieces of paper

This is the whole page in one line: leave with paper, or spend the next fortnight on the phone reconstructing it.

Ask for a printed copy of each. "It has been sent to the doctor" is not a copy, and it does not help you at 10pm.

• The written discharge summary — the document itself, not a verbal version
• The medicine list as issued on discharge, dated today, showing what changed while your parent was in
• A written note of what was physically handed to you: which boxes, how many days each covers, and who supplies the next lot
• Every follow-up appointment: date, department, location, phone number, and who books it if it is not booked yet
• Every referral made: the name of the service, when they should make contact, and the number to call if they do not

Questions for the discharge nurse

Write these out before the conversation and hold the page. A discharge nurse is running four discharges at once and will answer what you ask, not what you meant to ask.

Ask them in this order, and write the answers on the page rather than trusting your memory of a corridor conversation.

• What changed on the medicine list while my parent was here, and who explains those changes to us?
• Which medicines are going home with us today, and how many days does that cover?
• Who orders the next supply, by when, and does the pharmacy already know?
• What should we write down at home over the next two weeks, and who do we send it to?
• What number do we call tonight if something worries us — and what is the number after hours?
• Who is the named contact on this ward for the next 48 hours?
• What has been referred, and when should we expect to be contacted?
• What is being delivered to the house, by whom, and on what day?
• Is there anything my parent should not do at home for now?
• Can we have all of that in writing before we go?

Equipment, deliveries and getting home

Two things regularly derail the first day home: something was promised for delivery and did not arrive, and nobody worked out how a person who cannot manage stairs gets up the stairs.

For anything being delivered, write down the supplier's name, a reference number, a phone number and a date. Then call the supplier yourself before you leave the hospital and confirm all four. A delivery arranged by someone else, for a house you are not in, is not arranged.

For transport, confirm who is driving, where they can stop, and whether anyone is meeting you at the other end. If hospital transport is booked, get the reference and ask what the realistic wait is — it is often several hours after the bed is needed.

Walk the route in your head before you set off: car to door, door to chair, chair to bathroom, bathroom to bed. If any of those four moves does not work today, say so on the ward before you leave rather than discovering it in the dark.

• Supplier name, reference, phone and delivery date for every item promised
• A confirmation call made by you, from the ward, before you leave
• Who is driving, where they can stop, who meets you at the house
• The four moves: car to door, door to chair, chair to bathroom, bathroom to bed

The first 48 hours: what to write down

Keep one sheet on the kitchen table and write on it every time anything happens. Not a diary. A log.

Each line gets a date, a time, and a plain observation of what you saw, heard or were told. "Tuesday 14:20 — district nurse visited, name Julie Kerr, next visit Thursday am" is a log entry. So is "Wednesday 09:10 — pharmacy called, two items out of stock, will ring back Friday". Record what happened, never what you think it means.

This matters for three reasons. The professional who calls on day three will ask, and a written answer with times is worth more than a recollection. The sibling who was not there gets a record instead of an argument. And if you have to call anyone, you are reading rather than remembering.

Write down the name and time of every professional who telephones or visits, every delivery, every call you make and to whom, and anything you were told to expect that has not yet happened. That last column is the one that gets things chased.

• Date | Time | What happened or what was said | Who said it | Action still open
• Every professional contact, with name, role and phone number
• Every delivery expected, and whether it arrived
• Every call you made, to whom, and what they promised
• One line at the bottom of each day: what is still outstanding

File it within the week

Discharge paperwork has a short half-life on a kitchen counter. Give it twenty minutes before the weekend is out.

Photograph every page first and put the images in the shared folder, named with the date. That is the copy your sibling can see from three hundred miles away, and the one that survives a spilled cup of tea.

Then file the paper: discharge summary into the hospital section, newest at the front. The new medicine list replaces the old one on the master sheet — do not simply add it, or you will end up with two versions and no way to tell which is current. Write today's date at the top of the sheet that survives.

Appointments go into the shared calendar with the location and reference number in the entry. New phone numbers go onto the emergency contact sheet. Anything still outstanding goes onto a single "chasing" page with a date beside it and a name.

Then send five lines to whoever else is involved: date home, what changed, what is expected to arrive, what is booked, what you need from them.

Questions