Reconcile medications

Cross-check medications to ensure that no routine medications were stopped and that new prescriptions are safe for the patient to take.

Prescriptions for new or changed medication should be filled and reviewed with the patient and family at or before discharge.

Ensure follow-up

Communicate medication changes, pending tests, and follow-up needs to the primary care physician.

Transmit discharge summary to the primary care physician as soon as possible after discharge.

Schedule an outpatient follow-up visit before discharge.

Provide patient education

Ensure that the patient can identify the physician who will provide outpatient diabetes care.

Check the patient's level of understanding related to the diabetes diagnosis, self-monitoring of glucose levels, and blood glucose goals.

Reinforce information on nutritional habits, insulin administration, and other topics.

Prescribe medication regimen

Ensure that the patient has prescriptions for any new medications and does not have redundant prescriptions for existing home medications.

Review the role and regimen for oral diabetes medications, insulin regimens, and any other medication changes with patient.