Hospital Discharge Checklist — The 72 Hours

Before you leave the hospital

• ☐ Full written discharge summary in hand (not just verbal instructions)
• ☐ Every medication reconciled — old list vs new list, side-by-side. Discontinued meds are the #1 source of readmissions.
• ☐ Prescription bag verified — every med the summary lists is physically in the bag
• ☐ Home-health referral in place (skilled nursing / PT / OT), name and phone number of the agency
• ☐ Follow-up appointment scheduled before you leave — date, time, physician, location
• ☐ Equipment ordered (walker, hospital bed, oxygen, wheelchair) with delivery date confirmed
• ☐ Contact number for the discharge planner in case something is missing at home
• ☐ Any dietary restrictions written down (renal, cardiac, diabetic, swallowing precautions)
• ☐ Wound care instructions if applicable (frequency, supplies, when to call physician)

First 24 hours at home

• ☐ Ride home arranged — not driving self, not a rideshare with a stranger for a fragile patient
• ☐ Bedroom set up before arrival: bed rail, path to bathroom clear, walker in position, phone reachable
• ☐ Pillbox filled from the pharmacy bag — visible check against the discharge summary
• ☐ First doses given on schedule; second-check by a family member
• ☐ Someone in the house tonight, awake enough to notice if something changes
• ☐ Emergency contacts posted on the fridge (primary physician, cardiologist / specialist, nearest ER)
• ☐ Refrigerator stocked — the patient should not be hungry and reaching for something on the counter

Hours 24–72: the danger window

Watch for the three signs that precede most readmissions. If you see any of these, call the physician the same day:

1. New confusion or agitation — most often a UTI or medication side-effect, not the underlying condition
2. Low urine output or dark urine — dehydration is the #1 cause of hospital-to-hospital bounce-backs
3. Fever, chills, or a new productive cough — infection presenting in a person whose immune system is already stressed

Also watch for:

• ☐ Any medication missed (write it down; do not double up without physician instruction)
• ☐ Any fall or near-fall (write it down with time and circumstance)
• ☐ Weight change (fluid retention in heart-failure patients can be catastrophic)
• ☐ Wound redness, drainage, or new pain
• ☐ Difficulty urinating or bowel movement (post-anaesthesia constipation is common and can escalate)

Coordination the family should do

• ☐ Call the home-health agency by day 2 to schedule the first nurse visit
• ☐ Reconfirm the follow-up appointment with the primary physician
• ☐ Call the specialist (cardiologist, neurologist, orthopedic surgeon) to schedule their follow-up
• ☐ Notify the LTCI carrier if this discharge triggers new benefit eligibility
• ☐ Update the family group text or email — siblings in other cities need to know what changed

When to call 911 vs the physician

Call 911 immediately for: chest pain, sudden severe shortness of breath, stroke signs (facial droop, arm weakness, slurred speech), sudden severe headache, seizure, loss of consciousness, uncontrolled bleeding.

Call the physician same day for: new confusion, low urine output, fever, wound changes, unexplained pain, medication reaction, fall without obvious injury.

Call the physician within 48 hours for: gradual changes in appetite, sleep, mood, or mobility.

Where our Safe Return Home program fits

This checklist is what a family caregiver would use. Our Safe Return Home program covers the same 72-hour window with a professional caregiver in the home and a Care Manager (RN) coordinating in real time. If the family cannot personally cover the first three nights — long-distance siblings, working spouses, or a parent living alone — book Safe Return Home before the discharge, not after.

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