normal medication regimen should also be noted The Joint Commission requires a complete, reconciled list of the patient’s medications provided directly to the patient/guardian All newly prescribed medications should be listed on the hospital discharge instruction form in addition to including directions to continue, modify, or discontinue previously prescribed medications FOLLOW-UP Compliance with outpatient physician follow-up is improved if an appointment is made prior to discharge from the ED It is helpful to provide phone numbers for primary care physicians (especially for patients who not have a primary physician) and for subspecialists Discharge instructions can reinforce the importance of follow-up with the patient’s medical home, and encourage families to coordinate their follow-up care with their primary provider SUMMARY Discharge instructions are an integral part of the ED experience and are crucial for optimal continued care of the acute medical condition Many patients/guardians not fully comprehend discharge instructions, especially those with low literacy skills or low health literacy Discharge instructions should be reviewed orally by the primary practitioner or nurse who cared for the patient The person providing instructions should provide an opportunity for the patient/guardian to clarify any remaining questions concerning care prior to discharge Well-designed discharge instructions should be concise, with organized structure, including visual cues to enhance recall, and should be presented verbally with a summary written component Both verbal and written instructions should be provided in the patient/guardian’s native language when possible, and should be written at or below a 6th grade level using lay medical terms They should review the key components to discharge, including patient diagnosis, anticipated length of illness, home care, and return precautions, and should include information about newly prescribed medications and changes to prior medication regimens The understanding of and receipt of the instructions should be confirmed by one of the main care providers The use of technology will continue to expand the options for delivery of discharge