Patient Discharge and Referring Physician Interface

Rationale

When patients come to the Clinical Center to participate in clinical research, they expect the clinical staff to explain the results of testing, procedures performed, and management recommendations to them, and upon the patients' discharge, to provide these explanations to their physicians to ensure appropriate continuity of care.

Standard

Care teams that may include the attending physician or dentist, fellows, other licensed independent health-care practitioners, research nurses, and patient-care unit nursing staff will meet with patients (with a translator, if necessary, and with family or others, if requested) at the time of their discharge to explain their evaluation, treatment, and management recommendations as well as the follow-up that may be required at the Clinical Center. The care teams will provide patients with a form containing (at a minimum) discharge instructions, their medication list, and a contact phone number at the Clinical Center.

Referring physicians will receive a concise summary of evaluation, treatment, and management recommendations from the responsible attending physician or other designated licensed independent practitioner within a week of discharge, or earlier if necessary for appropriate continuity of care. In addition, they will receive a more detailed admission and discharge summary from a staff practitioner or fellow.

The attending physician’s letter should provide a phone or pager number in case the patient or referring physician has questions or concerns. The attending physician or a staff practitioner or fellow should convey more urgent issues to the referring physician by phone conversation prior to, or at the time of, discharge.