Hospital Checklist to Improve Staff Coordination

Hospital Checklist to Improve Staff Coordination

Student’s Name

Institution

Hospital Checklist to Improve Staff Coordination

1. Admission

Name of Admitting officer:

………………………………………………………….

Date of Admission: ………………………………

Age of patient

Gender; tick as appropriate

MaleFemale

Complaints:

……………………………………………………………………………………………………………………………………….

Blood Pressure: ………………………………….

Patient History

Prior Illnesses: ……………………………………………………………………………………………………………………………………….

Prior Diagnoses: ……………………………………………………………………………………………………………………………………….

Illness status:

Acute Bad

Ward Admitted to: ……………………….

Sign

2. Treatment:

Name of Checking Officer:

…………………………………………………………………

Do you confirm having confer with the Admission Details

YesNo

Patient Status:

AcuteBadFairly ill

Diagnosis

……………………………………………………………………………………………………………………………………………………………………………………………………………

Medical Recommendations

…………………………………………………………………………………………………………………………………………………………………………………………………………….

Information communicated to Patient

…………………………………………………………………………………………………………………………………………………………………………………………………..

Patient Response to treatment:

……………………………………………………………………………………………………………………………………………………………………………………………………..

Sign: ____________

3. Pharmaceutical Check

Name of Checking Officer:

……………………………………………………………………………………………………………………………………….

Do you confer having read the valuations and recommendations of the previous officers:

yes no

Do you agree with recommendations

If no, then why? ………………………………………………………………………………………………………………………………………

If you do not agree, please confirm communicating to the officer concerned:

YesNo

Recommendations;

………………………………………………………………………………………………………………………………………………………………………………………..

Patient Response to medical dosage:

…………………………………………………………………………………………………………………………………………………………………………..

Sign

4. Care:

Name of caring officer:

…………………………………………………………………………………………………………………………………………

Please confirm having read all the recommendations and evaluations of the previous officer:

Further Recommendations:

……………………………………………………………………………………………………………………………………………………………………………………………………….

Information communicated to patient:

……………………………………………………………………………………………………………………………………………………………………………………………………..

Patient Response to care:

…………………………………………………………………………………………………………………………………………………………………………………………..

4. Discharge:

Discharging officer

………………………………………………………………………………………………………………………………………..

Do you confirm having read the recommendations and evaluation of the previous officers?

YesNo

Patient Status

ImprovedNo improvement

Evaluation/ Recommendations:

……………………………………………………………………………………………………………………………………………………..

Reason for Discharge:

ImprovedReferred

Information Communicated to Patient

Medical Bill: ……………………………………………..

(Please tick as appropriate)

ClearedNot cleared

Sign: ……………………

Date of discharge: ………………………….