Discharge Advocate's Data Collection Tool

Project RED (Re-Engineered Discharge) Training Program

The Discharge Advocate (DA) can use this form to note dates and times for the activities listed in the left column. Once it is complete, it should be sent to the project team leader for data entry.

Discharge Advocate's Data Collection Tool

The Discharge Advocate (DA) can use this form to note dates and times for the activities listed in the left column. Once it is complete, it should be sent to the project team leader for data entry.

Data To CollectPatient 1Patient 2Patient 3Patient 4
    
Patient Name    
Patient Location    
Date and Time of Admission    
Date and Time DA Notified    
Patient Meets All Inclusion Criteria?___  Yes   ___  No___  Yes   ___  No___  Yes   ___  No___  Yes  ___  No
Date and Time of Initial DA Visit With Patient    
Date(s) and Time(s) of Daily DA Visits With Patient (Note All)    
     
     
     
     
     
     
     
     
     
     
Date and Time of Discharge    
Date and Time Care Plan Faxed to Primary Care Physician    
Date(s) and Time(s) of Post-Discharge Call (Note All)    
     

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Current as of August 2011
Internet Citation: Discharge Advocate's Data Collection Tool: Project RED (Re-Engineered Discharge) Training Program. August 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/red/datatool.html