Copy and edit this outline:
Follow-up:
Who is responsible for follow-up, and when is the first appointment?
Who is responsible for follow-up, and when is the first appointment?
Medication:
What is the medication plan, what changes were made, and who should be contacted about side effects?
What is the medication plan, what changes were made, and who should be contacted about side effects?
Warning signs:
What changes should prompt an urgent call or return to hospital?
What changes should prompt an urgent call or return to hospital?
Housing and daily needs:
Where will the person stay, and what support is in place for food, transportation and appointments?
Where will the person stay, and what support is in place for food, transportation and appointments?
Information-sharing:
What information can be shared with the family, and who can receive collateral information?
What information can be shared with the family, and who can receive collateral information?
Written plan:
Please provide the patient and appropriate caregivers with the written discharge and crisis plan.
Please provide the patient and appropriate caregivers with the written discharge and crisis plan.
Sincerely,
[Name]
[Contact information]