PURPOSE: The purpose of this quality improvement (QI) project was to improve the case management discharge instructions for patients in an inpatient psychiatric and medical unit. It utilized very specific directions on how to address disease progression symptoms outside of the acute care setting in an effort to achieve readmission rates below the 10th percentile (the unit desired). The current case management discharge process was modified in three ways, including: 1) modification of the case management discharge instructions into a user-friendly, one-page format written on a fifth-grade reading level, 2) dividing the discharge instructions section of warning signs into three categories: mild, moderate, and severe symptoms, and 3) the inclusion of a treatment sheet into the new discharge instructions which was given to the patient at discharge. Chart audits, interviews, observation, and pre- and post-intervention surveys were methods used to collect data regarding patient and nurse perceptions of the usefulness of the discharge instructions, as well as compliance with the new discharge process. OUTCOMES: User-friendliness of the discharge instruction was improved significantly from 20% to 87%. Post implementation, all nurses instructed patients about the warning symptoms on the new discharge form. The completion of the discharge compliance summary improved from 75% to 100%. IMPACT: The nurses and QI team reported satisfaction with the new form’s content and user-friendliness, increasing the likelihood that it will be used and potentially reduce readmission rates
