Patient Interview/readmission Chart Review Page 7
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12Did patient keep appointment with MD yes no if no, why ___________________________
Issues identified upon admission to home health
Patient had all meds on admit to home health
YES NO (elaborate)
If no did not have RX yes no could not afford
Yes
No
Patient compliant with meds
Yes
No (elaborate)
Physician Order discrepancies
YES (elaborate) NO
Lack of understanding of discharge instructions
YES (elaborate)
NO
If discharged from hospitalists, was there a handoff with PCP and did PCP respond to questions or
patient issues
During the time between admission to home health and readmission to hospital were there any issues
and how were they addressed?
In your opinion what were the top home health reasons why patient was readmitted
1.
2.
3.
Any other comments
Outpatient Services Readmission Review
1. PATIENT IDENTIFIER
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