Uncertainty Communication Checklist for Patient Discharge



Introduction

1. Explain to the patient that they are being discharged

2. Ask if there is anyone else whom the patient wishes to have included in the conversation in person and/or by phone

Test results/ED summary

3. Clearly state that either “life-threatening” or “dangerous” conditions have not been found

4. Discuss diagnoses that were considered (using both medical and lay terminology)

5. Communicate relevant results of tests to patients (normal or abnormal)

6. Ask patient if there are any questions about testing and/or results

7. Ask patient if they were expecting anything else to be done during their encounter—if yes, address reasons not done

No/uncertain diagnosis

8. Discuss possible alternate or working diagnoses

9. Clearly state that there is not a confirmed explanation (diagnosis) for what the patient has been experiencing

10. Validate the patient’s symptoms

11. Discuss that the ED role is to identify conditions that require immediate attention

12. Normalize leaving the ED with uncertainty

Next steps/follow-up

13. Suggest realistic expectations/trajectory for symptoms

14. Discuss next tests that are needed, if any

15. Discuss who to see next and in what time frame

Home care

16. Discuss a plan for managing symptoms at home

17. Discuss any medication changes

18. Ask patient if there are any questions and/or anticipated problems related to next steps (selfcare and future medical care) after discharge

Reasons to return

19. Discuss what symptoms should prompt immediate return to the ED

General communication skills

20. Make eye contact

21. Ask patient if there are any other questions or concerns



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