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  1. www.ahrq.gov/news/newsroom/case-studies/cquips1210.html
    August 01, 2012 - patient safety researchers in Boston, provides evidence-based tools to help hospitals re-engineer their patientdischarge processes. … The booklet, "Steps to Home," involves patients more in their discharge planning so they will be better … It uses a "traffic light" system to move the patients through various stages of discharge planning, including
  2. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/mcaidread_tool8_cop_handout.docx
    November 01, 2015 - planning, now referred to as “transitional care.” … Have a documented discharge planning process, approved by the hospital’s governing board; Provide dischargeplanning for all inpatients, observation patients, and certain ED patients; Analyze and track readmission … readmissions to look for patterns; Conduct root cause analyses on readmissions to assess whether the dischargeplanning process meets patients’ needs; Craft a discharge plan that can be realistically implemented
  3. www.ahrq.gov/patient-safety/about/areas/improve-discharge.html
    August 01, 2024 - Resources To Cut Readmissions, Promote Patient Self-Management AHRQ's RED Toolkit Inspires Improved PatientDischarge at Nacogdoches Memorial Hospital AHRQ's RED Toolkit Leads to Lower Readmissions, Better Care … Transitions in Two Texas Hospitals IDEAL Discharge Planning Improving the Emergency Department Discharge … AHRQ PSNet Perspective: Transitions in Care, In Conversation With Eric Coleman AHRQ PSNet Primer:  DischargePlanning and Transitions of Care Related Patient Safety and Quality Resources and Tools Cross-Cutting
  4. 0129Table8 (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0129table8.pdf
    January 01, 2013 - Comprehensive discharge planning with discharge planning plus post-discharge support on readmission … Discharge planning from hospital to home. … The intervention group received: 1) a comprehensive, user- friendly patient discharge form; 2) electronic … transfer of the patient discharge form to nurses at the primary care provider site; 3) telephone … Public reporting of discharge planning and rates of readmissions.
  5. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-care-transitions5.html
    June 01, 2023 - to improve the safety of the inpatient-to-outpatient transition and engage patients and families in dischargeplanning through a novel IDEAL Discharge Planning strategy. 93 This systematic framework focuses on … : I ncluding patients and families as full partners in discharge planning, D iscussing with patients
  6. www.ahrq.gov/ncepcr/care/coordination/atlas/chapter6n.html
    June 01, 2014 - The development, validity and application of a new instrument to assess the quality of discharge planningDischarge planning quality from the carer perspective. Qual Life Res 2000;9:1005-13. … The development, validity and application of a new instrument to assess the quality of discharge planning … The development, validity and application of a new instrument to assess the quality of discharge planningDischarge planning scale: Community physicians' perspective. J Hosp Med 2008;3(6):455-64. 3.
  7. www.ahrq.gov/hai/cusp/modules/patient-family-engagement/sl-pat-fam.html
    September 01, 2013 - IDEAL Discharge Planning Slide 17. What Is IDEAL Discharge Planning? 1 Slide 18. … Benefits of IDEAL Discharge Planning for Clinicians 1 Slide 19. IDEAL Discharge Slide 20. … IDEAL Discharge Planning Return to Contents   Slide 17. What Is IDEAL Discharge Planning? … Benefits of IDEAL Discharge Planning for Clinicians 1 Improves accuracy of information about the … IDEAL Discharge Planning is an effective tool for ensuring patient and family member engagement and education
  8. www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-131-section-5-table-8-9.pdf
    January 01, 2013 - Discharge planning from hospital to home. … The intervention group received: (1) a comprehensive, user-friendly patient discharge form; (2) electronic … transfer of the patient discharge form to nurses at the primary care provider site; (3) telephone … Forty- Evaluating hospital discharge planning: a randomized clinical trial. … Public reporting of discharge planning and rates of readmissions.
  9. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_to_Use_Guide_Ldr_Slide_508.pptx
    July 23, 2010 - Involving patients and families in discharge planning and plans for safe care at home. … Nurs Adm Q 2006;30(2):112–22.  14 Why focus on discharge planning? … A review of discharge planning research of older adults 1990-2008. … Hospital discharge planning for frail older people and their family. … Discharge planning from hospital to home. Cochrane Database Syst Rev 2010;20(1):CD000313.
  10. www.ahrq.gov/hai/cusp/modules/patient-family-engagement/notes.html
    September 01, 2013 - IDEAL Discharge Planning Slide 17. What Is IDEAL Discharge Planning? 1 Slide 18. … IDEAL Discharge Planning The following section discusses the IDEAL Discharge Planning tool and how … to use it in discharge planning. … What Is IDEAL Discharge Planning? … Benefits of IDEAL Discharge Planning for Clinicians 1 Say: Using the IDEAL discharge planning process
  11. www.ahrq.gov/patient-safety/reports/issue-briefs/dxsafety-care-transitions5.html
    June 01, 2023 - to improve the safety of the inpatient-to-outpatient transition and engage patients and families in dischargeplanning through a novel IDEAL Discharge Planning strategy. 93 This systematic framework focuses on … : I ncluding patients and families as full partners in discharge planning, D iscussing with patients
  12. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_to_Use_Guide_Ldr_Slide_508.pdf
    May 14, 2013 - Working with Patients and Families at the Bedside: Care Transitions from Hospital to Home: IDEAL DischargePlanning 11 Information to Help Hospitals Get Started Why work with patients and families as … planning? … planning – Changes in medicines before and after discharge – Inadequate preparation for patients and … Why focus on discharge planning? Moving forward What do we need from you?
  13. www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/CUSP-Patient-Family-Engagement.pptx
    May 01, 2013 - family for calling attention to any issue raised Invite them to continue asking questions IDEAL DischargePlanning What is IDEAL Discharge Planning? … Planning for Clinicians1 Improves accuracy of information about the patient’s condition and discharge … members of the health care team impacts health outcomes and patient and family satisfaction IDEAL DischargePlanning is an effective tool for ensuring patient and family member engagement and education Organizations
  14. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/care-transitions-1.pdf
    March 01, 2020 - AB “Discharge Planning” OR "Patient Discharge" OR "Patient Transfer" OR "Patient Handoff"))) (( … AB “Discharge Planning” OR "Patient Discharge" OR ((AB “Care Transitions Intervention” OR “CTI”) … AB “Discharge Planning” OR "Patient Discharge" OR "Patient Transfer" OR "Patient Handoff"))) (( … Discharge” OR “Patient Transfer” OR "Patient Handoff”) OR (AB “Discharge Planning” OR "Patient Discharge … AB “Discharge Planning” OR "Patient Discharge" OR "Patient Transfer" OR "Patient Handoff"))) ((
  15. www.ahrq.gov/es/patient-safety/settings/hospital/resource/nicu/coaching.html
    December 01, 2013 - Prioritize patient visits for the day: New patients—while discharge planning should always "begin … Discharge planning (insurance coverage, pediatrician contact information and appointment date, CPR education
  16. www.ahrq.gov/patient-safety/settings/hospital/resource/nicu/coaching.html
    December 01, 2013 - Prioritize patient visits for the day: New patients—while discharge planning should always "begin … Discharge planning (insurance coverage, pediatrician contact information and appointment date, CPR education
  17. www.ahrq.gov/es/patient-safety/settings/hospital/red/toolkit/redtool1.html
    March 01, 2013 - that national quality organizations have begun to set standards to address some of the deficiencies of dischargeplanning. … A Cochrane review of discharge planning interventions indicated that a number of interventions did not … of integrating the discharge education functions into the duties of the staff nurse responsible for patientdischarge versus a strategy of hiring dedicated discharge educators to perform these functions.
  18. www.ahrq.gov/patient-safety/settings/hospital/red/toolkit/redtool1.html
    March 01, 2013 - that national quality organizations have begun to set standards to address some of the deficiencies of dischargeplanning. … A Cochrane review of discharge planning interventions indicated that a number of interventions did not … of integrating the discharge education functions into the duties of the staff nurse responsible for patientdischarge versus a strategy of hiring dedicated discharge educators to perform these functions.
  19. www.ahrq.gov/topics/transitions-care.html
    in Safe Transitions Across Ambulatory Settings Care Transitions from Hospital to Home: The IDEAL DischargePlanning MATCH Toolkit (Medications at Transitions and Clinical Handoffs) Taking Care of Myself:
  20. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/medread-tools.pdf
    July 28, 2016 - Incorporate into regular discharge planning assessment and referrals. …  Have a documented discharge planning process, approved by the hospital’s governing board;  Provide … discharge planning for all inpatients, observation patients, and certain ED patients;  Analyze and … Time Required Incorporate into regular discharge planning assessment and referrals. … 2015 proposed CMS Discharge Planning Conditions of Participation (Medicare and Medicaid programs revision

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