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Informed discharge


Alerting patients to warning symptoms and signs

Follow-up


Follow-up instructions

  • Inform the patient about who is the most responsible health professional for follow-up care.

When a patient is discharged from a physician's care, the patient should be made aware of any need for follow-up, who will be providing the follow-up, and how the arrangements will be made (i.e. appointments, etc.).

Who else needs to know?

  • Alert those health professionals who are responsible for follow-up care of the patient.

Case: Trouble in follow-up of an INR
Concerned-looking middle age male on telephone

Context

A 54-year-old male patient begins a course of anticoagulants prescribed by a consulting cardiologist. She instructs the patient to see his family physician to manage the International Normalized Ratio (INR).
Female nurse on telephone

Outcome

The patient calls the family physician for an appointment. The receptionist, who is not aware of the importance of the follow-up, arranges an appointment in three weeks. Unfortunately the patient dies from massive cerebral bleeding prior to being seen.

Think about it

How might this patient's outcome have been prevented?

Lessons learned

To facilitate continuity of care, the health professional responsible for following the patient after discharge should receive information about any outstanding investigations or any required follow-up testing.

The discharge information should be sufficient to enable ongoing care. In particular, the information should indicate the provider most responsible for following the patient and for arranging recommended investigations.

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If the patient has been given responsibility for making a follow-up appointment with another physician or healthcare provider, that healthcare provider should have been notified so that appropriate follow-up can be arranged.

If follow-up is perceived to be urgent, it is often helpful to contact the subsequent provider to verbally explain the clinical situation. Document your efforts in the medical record.