Uncertainty Communication Checklist for Patient Discharge Introduction 1. Explain to the patient that they are being discharged 2. Ask if there is anyone else whom the patient wishes to have included in the conversation in person and/or by phone Test results/ED summary 3. Clearly state that either “life-threatening” or “dangerous” conditions have not been found 4. Discuss diagnoses that were considered (using both medical and lay terminology) 5. Communicate relevant results of tests to patients (normal or abnormal) 6. Ask patient if there are any questions about testing and/or results 7. Ask patient if they were expecting anything else to be done during their encounter—if yes, address reasons not done No/uncertain diagnosis 8. Discuss possible alternate or working diagnoses 9. Clearly state that there is not a confirmed explanation (diagnosis) for what the patient has been experiencing 10. Validate the patient’s symptoms 11. Discuss that the ED role is to identify conditions that require immediate attention 12. Normalize leaving the ED with uncertainty Next steps/follow-up 13. Suggest realistic expectations/trajectory for symptoms 14. Discuss next tests that are needed, if any 15. Discuss who to see next and in what time frame Home care 16. Discuss a plan for managing symptoms at home 17. Discuss any medication changes 18. Ask patient if there are any questions and/or anticipated problems related to next steps (selfcare and future medical care) after discharge Reasons to return 19. Discuss what symptoms should prompt immediate return to the ED General communication skills 20. Make eye contact 21. Ask patient if there are any other questions or concerns #Uncertainty #Communication #Checklist #Discharge #Management #Disposition
