It’s a SMART thing to do

It’s a SMART thing to do


Last year, Anne Arundel Medical Center was one of just 20 hospitals in the country to be awarded a Picker Institute Always Events® grant. These grants define elements of the patient experience that should be part of every interaction between a patient and/or family and the healthcare system. Our institution created and proposed the SMART Discharge Protocol, a framework to ensure five key areas are addressed during hospitalization and at discharge:  Symptoms, Medications, Appointments, Results and Talk.

Three units are currently piloting the protocol:  Medical Surgical, Neonatal Intensive Care, and Heart and Vascular.  Nurses, physicians, IS analysts, patient-family advisors, therapists and others have participated in training and implementation strategies to make this project a success. Most notably, this team can be credited with the After Visit Summary (AVS) improvements that went live on all inpatient areas in August 2012. The group will continue to work on the AVS in FY ’13, with a focus on discharge process standardization housewide.

To measure improvement, AVS instructions are being audited for the five SMART components. Follow-up phone calls to NICU families and high risk for readmission patients are being made by askAAMC nurses, and 30 day readmission rates, ED visit rates, and patient satisfaction are being tracked on MSU, NICU and HVU. So far, ED visits and readmission rates on MSU and NICU have improved, while patient satisfaction scores on MSU have increased.  More importantly, when the askAAMC nurses make phone calls, patients and families are verbalizing that symptoms, medications, and appointments are being discussed in the hospital and they feel all their questions were addressed prior to discharge. As more data comes in, the SMART Discharge Protocol will be developed further.

AAMC has presented the SMART Discharge Protocol at a variety of forums including: the International Patient-Family Centered Care conference, Institute for Healthcare Improvement (IHI) Leadership conference, Maryland Patient Safety Center’s MEDSAFE and Perinatal-Neonatal Collaborative conferences, and at the Maryland Nurses Association convention. For more information on the Picker Institute Always Events®, please click here.

Questions about SMART? Contact Kristina Andersen at

-Kristina Andersen, RN

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