<p> Chart Review of Patients Who Were Readmitted</p><p>Conduct chart reviews of the last five readmitted patients. Reviewers should be health care team member or experienced in the clinical setting and in chart review for quality and safety. Reviewers should not look at assign blame, but rather to discover opportunities to improve the care of patients. </p><p>Question Patient #1 Patient #2 Patient #3 Patient #4 Patient #5 Number of days between the last discharge and this _____Days _____Days _____Days _____Days _____Days readmission date. Was the follow-up Yes No Yes No Yes No Yes No Yes No physician visit scheduled prior to discharge? If yes, was the Yes No Yes No Yes No Yes No Yes No patient able to attend the office visit? Were there any Yes No Yes No Yes No Yes No Yes No urgent clinic/ED visits before readmission? Functional status of Comments: Comments: Comments: Comments: Comments: the patient on discharge? Was a clear Yes No Yes No Yes No Yes No Yes No discharge plan documented? Was evidence of Yes No Yes No Yes No Yes No Yes No Teach Back documented? List any documented Comments: Comments: Comments: Comments: Comments: reason/s for readmission. Did any social Yes No Yes No Yes No Yes No Yes No conditions (transportation, lack of money for medication, lack of housing) contribute to the readmission?</p><p>July 2011. Adapted from Rutherford P, Nielsen GA, Taylor J, Bradke P, Coleman E. How-to Guide: Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations. Cambridge, MA: Institute for Healthcare Improvement. June 2011.</p>