Coordinating a successful transition to the next setting (whether to another agency or facility, another unit within the same facility, or to home under the care of community physicians) by employing effective handoff communication.
Project BOOST's Patient PASS: A Transition Record (adapt for family caregiver)
Points to Consider: Effective handoff communication is a skill that needs to be learned and practiced. Verbal and written reports that are unorganized are often ineffective and can delay the implementation of essential care, which can put patients at risk for adverse events.
Aiming to make the final discharge instructions with the family caregiver a simple review of what has already been taught.
Project BOOST's Discharge Preparation Education Tool (DPET) (adapt for family caregiver)
Medication Management Form (in English, Spanish, Russian, and Chinese)
Points to Consider: Education is about the right information learned at the right time by the right person. Discharges, which are often characterized by stress and confusion, are NOT the right time to begin education and training. The family caregiver who will be doing or assisting with those tasks may not even be present at discharge. A review of previously taught information can be done via telephone with the appropriate family caregiver.