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Post-Discharge Follow-up Phone Call
Post-Discharge Follow-up Phone Call
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Created by Qualaris Staff
Critical Access Hospital
Case Management
Learn more about managing Nursing data with Qualaris
Table of Contents
Audit Form
Audit Form
Post-Discharge Follow-up Phone Call
Description
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Required
Observed Date
Unit
ED
ICU
Med-Surg
PACU
Rehab
Risk for Readmission
Low
High
Call Made By
Case Management
RN
Secretary
VP Outpatient Services
Office Practice Manager
Is there anything that you feel that we could have done differently to improve our services?
Do not enter protected health information (PHI)
Post-Discharge Follow-up Phone Call Checklist
Mark all as...
Was the follow-up call placed within 48 hours of Pt discharge?
Yes
No
Assessment of Pt current health status completed?
Yes
No
Was Pt given disease or condition specific information at discharge?
Yes
No
Was Pt given written info about when and how to seek medical attention if a problem arises?
Yes
No
N/A
Was Pt able to get all prescriptions filled?
Yes
No
N/A
Is Pt able to repeat back instructions for new medications?
Yes
No
N/A
Was follow-up appointment scheduled prior to discharge?
Yes
No
Was Pt able/Will they be able to attend the follow-up appointment as scheduled?
Yes
No
N/A
If Pt has home health care, has agency contacted or visited them?
Yes
No
N/A
Did the medical supply company deliver needed equipment?
Yes
No
N/A
If Pt has specialized diet, did they receive dietary advice?
Yes
No
N/A
If Pt has a wound or incision, did they receive care instructions?
Yes
No
N/A
If patient has diagnosis of CHF do they have access to an accurate scale?
Yes
No
N/A
If patient has a diagnosis of CHF were they given a weight chart to document their daily weight?
Yes
No
N/A
