# Implementation of a New Discharge Card in the Department of Internal Medicine at Almanagil Teaching Hospital: A Quality Improvement Project

## TL;DR

A new discharge card improved patient safety and documentation completeness in a hospital's internal medicine department.

## Contribution

A reproducible model for improving discharge documentation in resource-limited healthcare settings.

## Key findings

- Patient identifier compliance reached 98%-100% after implementation.
- Clinical documentation completeness improved significantly, with allergy status reaching 100%.
- Follow-up planning improved from 10% to 90% compliance.

## Abstract

Background: Inadequate discharge documentation in the Internal Medicine Department of Almanagil Teaching Hospital threatened patient safety, contributing to medication errors and disrupted care. This project implemented a standardized discharge card to address major deficiencies identified by initial audits.

Methods: Using a pre-/post-intervention design (July 1 to August 1, 2025), an initial audit of 50 records allowed for the joint creation of a structured discharge card. Staff training came before the implementation period, followed by a later audit of 50 records to evaluate completeness against 52 varied parameters. Statistical significance (p<0.05) was calculated using chi-square analysis.

Results: The post-intervention period showed considerable improvement: patient identifier compliance approached complete adherence (contact details: 0% to 98%-100%), clinical documentation improved significantly (allergy status: 0% to 100%; discharge medications: 42% to 98%), and follow-up planning notably improved (follow-up date: 10% to 90%). Over 85% of parameters showed statistically significant improvements, with 32 of 52 key fields reaching compliance rates of 98% and higher.

Conclusion: Implementing standardized discharge documentation and focused staff training significantly enhanced record completeness in this resource-limited environment. While ongoing issues with complex patient histories and discharge procedures require further attention, this model provides a reproducible solution for improving care transitions in similar healthcare settings, particularly in low- and middle-income countries where standardized discharge processes are less established.