D/C instructions

Hi all,

Just closing a complaint that has brought to front how important our discharge messaging is!!

The patient and mom understand clearly heard that a fracture could be missed on first ED visit from the verbal discharge instructions, by the ED doc, ( due to growth plates) but didn’t seek care for over three weeks after the initial injury because it ” was getting better slowly” and they understood it shouldn’t be if a break was missed.

It was actually a missed tibial fracture by the ED doc and radiologist. It is clearly on the x-ray but is a commonly missed break in this case!

If they had been told “if still any pain in one week to 10 days see an MD” that would have prevented a delayed presentation of a missed fracture.
That is now how specific I have become on my discharge instructions and I think super helpful for all to hear about this case.

ALSO – reminder to use written d/c instructions whenever possible!! In HDMH I am even sending our PA away to write these up for me and then when ready bring them to me to edit or give to patient.

John