Timeout Before Checking Out

Summary and Comment |
April 28, 2014

Timeout Before Checking Out

  1. Grace C. Huang, MD

A discharge timeout process prevented prescribing errors.

  1. Grace C. Huang, MD

During hospitalization and subsequent discharge, medications often are modified or changed, which can be a source of confusion for patients and providers and can result in medication errors. Investigators at an 885-bed academic teaching facility examined the rate of prescribing errors during 60 days before and after instituting a discharge timeout process whereby all members of the medical team met to review the patient record and complete a standardized discharge form.

The timeout was completed in 2 to 3 minutes; it included a review by a clinical pharmacist who compared the patient's home medical regimen with the inpatient list of medications. The pharmacist and medical team then came to a consensus on discharge drug regimen and length of treatment. Pharmacists and case managers discussed financial and psychosocial barriers to drug availability. Prescribing errors were detected in 35% of 142 discharges before the intervention and in 13% of 124 discharges after the intervention. Adherence to the timeout process was 93%.


Among standardized discharge practices, a timeout to review patient records might prove effective. However, this study's design does not reveal where the ultimate credit lies: Is it the pharmacist presence, the team's review of medications, the dedicated time spent, or the standardized form? The process did not involve the patient, the single reviewer was not blinded to the pre- and post-study periods, and adverse events were not tracked. Nevertheless, a brief team-based interaction eventually could join the arsenal of safety practices.

Editor Disclosures at Time of Publication

  • Disclosures for Grace C. Huang, MD at time of publication Equity Pfizer Grant / research support Health Resources and Services Administration; National Cancer Institute; CRICO/RMF; Radiological Society of North America Editorial boards Simulation in Healthcare; MedEdPORTAL; Hospital Medicine clinics


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