142 Chapter 6 Supplement 2 Criteria for inclusion: ✓ Specialism + ED or Fast track » ED ✓ Discharged from ED home ✓ Caretaker present when patient has a cognitive impairment ✓ 70 years of age and above Patient Sticker Note reason:………………………….. ………………………………………….. Patient will NOT be included. Put form in map ‘Exclusion’. Inform the nurse and ED doctor that the patient meets the criteria to be included in this study. Research assistent wants to be present at the moment discharge instructions are given. Make notes on the following domains and register in database ‘pre’ or ‘post’. Do not forget to hand out the questionnaire to the patient on paper for the telephone follow-up. 1. Discharge instructions given? Yes No 2. Instructions given on the following domains; a. Diagnosis and treatment; Notes: …………………. b. Prescribed medication (also the instructions given); Notes: …………………. c. Post-ED care (wound care, lifestyle advice, etc); Notes: …………………. d. Follow-up appointments (with GP, etc); Notes: …………………. e. Return precautions; Notes: …………………. 3. Caretaker present? Yes No 4. Was a discharge letter given to the patient? Yes No 5. Duration of discharge conversation: ……………….. minutes 6. Who gave instructions: Resident Nurse Physican Intern (multiple answers possible) 7. Appropriate times to call: ………………... Phone number: ………………... Protocol data collection Monday – Friday 10:00-19:00 Call the patient 1-3 days after discharge aided by the protocol ‘Telephone followup’ Register data from protcol ‘Telephone-followup’ in SPSS data base ‘zero-measurement. Register patient characteristics (var 1 t/m 28) in SPSS database ‘pre’/ ‘post’ Put signed form in map ‘Inclusion’; go to step 2 No Yes Signed informend consent? Finished BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s) Emerg Med J doi: 10.1136/emermed-2020-210168 –8. 2021;0:1 Emerg Med J , et al. Hesselink G
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