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Before you leave! Be sure you’ve checked o  all of these items!
o A Written ‘Discharge Summary’ Was Given To Me. This includes the reason for my hospital stay, my treatments, procedures, surgery, medications and prescriptions. I need to understand all of these things, including how to take care of myself when I get home.
o The Reason For My Hospital Stay Was Clearly Explained To Me Before Discharge. This includes tests, procedures, surgery, medications and plan of care in the hospital and when I am at home.
o My Questions Were Answered Clearly, So That I Understood Them. I should not leave the hospital until I understand how to take care of myself when I get home. I will ask if I do not understand.
o After My Questions Were Answered, I Could Explain The Answers In My Own
Words. It is important that I can show a clear
understanding of why I was in the hospital, my tests, procedures, surgery, medications, prescriptions and plan of care for when I leave.
o I’ve Made a List Of My Medications. This includes any new medications my doctor has
given me, how and when to take them and if they are safe to take with any other medications such as vitamin supplements or over-the- counter medications.
o My Pharmacy Has My New Prescriptions. Before
I leave the hospital, be sure I understand how and when to take my new medications.
o I’ve Written Down Follow Up Appointments with my doctor or tests I may need after I leave, and I know how I am getting to these appointments.
o I’ve Asked Questions About My Follow-Up Care such as, “Are there any limits on my activity or diet? or “ Do I need medical supplies?”.
o I’ve Asked If I Will Need Medical Supplies Or Equipment. This includes wheelchairs, hospital bed, oxygen or a walker. Know my approved local Medicare suppliers by visiting: Medicare.gov or calling
1-800 MEDICARE.
o I Know Who To Call
and What To Do in case I have questions after I leave and when
I get home. I have been given a phone number to call, and written it down or saved it in my phone.
o I Know What Warning Signs to look for or problems that might slow my recovery.
o I Know If I Have After- Hospital Services Needs for personal care such as help eating, dressing, going to the bathroom, cooking, shopping or doing laundry.
o I Know If I Need Help With Home Healthcare such as keeping up with or getting to doctor appointments, medication reminders, physical therapy, wound care, injections or medical equipment.
o I’ve Asked My Discharge Planner to Find Local Support Groups or after-care services
I may need.
o I Know I Can Visit
Heart Hospital Online Patient Center to conveniently and securely view test results, request an appointment, view health records, pay my hospital bill and more.
Enroll today by visiting HeartHospitalofLafayette.com or call (855) 359-0270.
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Don’t be afraid to ask the sta 
or discharge planner to repeat themselves if you don’t understand your discharge instructions!
BEFORE YOU LEAVE-DISCHARGE CHECKLIST


































































































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