Something I have made a point to teach all my medical students: the importance of a good discharge summary with SPECIFIC instructions that are appropriate to the patient’s ultimate dispo (example - SAR vs. PCP).

Here’s a thread on what I make a point to highlight.

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HOSPITAL COURSE: keep brief & big-picture (avoid detailing every med up-titration - overwhelming).

Things to include: rationale for meds they will leave on (ex- why Coumadin vs. DOAC?), abx course/duration, diagnostic rationale for key issues (such as presenting symptoms).

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DISCHARGE MEDS: make sure the list is up-to-date and concise (even if you use the smart phrases). When relevant/important, add home medications that were discontinued (and rationale) so that someone can get a sense of what overall CHANGES were made to pharmacopeia.

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FOLLOW UP APPOINTMENTS:
List ‘em - date, time, specialty, phone number or clinic location.

And if they haven’t been made, state how they will be scheduled (“patient will call” or “cardiology fellow will reach out once appointment is made”)

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FOLLOW UP TASKS: highlight things from the admission that should be tackled in the outpt setting. Be specific with your plans!

Started someone on iron for IDA? Recommend repeat studies after sustained therapy.

Find out someone is pre-diabetic? Suggest lifestyle mgmt!

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Note on the last one - as an intern this is so much easier said than done, but is a FANTASTIC exercise for my PCP brain, and also offers up many a learning opportunity when I touch base with consultants about discharge plans.

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This method of DC summaries seems like it would be a laborious and time-intensive process - but my commitment to brevity makes this a quick process!

PCPs and hospitalists of #medtwitter - anything to add here? Would love feedback on my process.

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