Discharge instruction check for ward teams

Nothing here is clinical advice, and nothing here should touch identifiable patient information.

Use this check when you need to turn an approved discharge template into a clinician-ready draft. It is for ward administrators and discharge coordinators who must preserve local wording, flag gaps, and make the instructions easier to read.

Keep the patient record in your approved local systems. The model receives only a blank template, approved wording blocks, and a non-patient-specific completion map.

1. Prepare three working documents

Create these documents before you open the model:

1. Approved wording sheet: copy the current locally approved text for each discharge section. Give every block an ID, such as FOLLOW-UP-01, MEDICINES-02, or RETURN-03.
2. Blank discharge template: use fields rather than patient details, for example [follow-up service], [appointment date], [medicine instruction], and [responsible clinician contact].
3. Record check sheet: review the patient record locally. Do not copy its contents. Record only whether each required field is complete, missing, conflicting, or needs clinician confirmation.

Your record check sheet might look like this:

Template field	Local record checked?	Status	Action needed
[follow-up service]	Yes	Complete	Insert locally
[appointment date]	Yes	Needs confirmation	Ask discharge coordinator
[medicine instruction]	Yes	Complete	Use approved wording only
[return precautions]	Yes	Conflicting	Clinician decision needed

Do not include names, dates of birth, addresses, hospital numbers, free-text record notes, appointment details, diagnoses, or medication details in the material sent to the model. A placeholder is enough for the wording task.

2. Mark what is fixed and what needs checking

Read the approved wording sheet once. Mark each block as one of the following:

• Fixed wording: must appear unchanged, apart from filling an authorised local field.
• Plain-language wording: may be simplified without changing its meaning.
• Clinician decision: cannot be resolved by an administrator, such as an inconsistency between the record and the intended instructions.
• Local completion: must be inserted from the record in your approved system after the draft is produced.

This separation matters. The model can make a sentence shorter. It cannot decide what information is correct for a particular patient.

If the behaviour or available settings of the model affect your process, check the current xAI documentation before using it with your organisation's approved setup.

3. Ask for a correction list first

Do not ask for a final letter as your first output. Start with the correction list. It makes missing fields and wording changes visible before a polished draft hides them.

Paste the blank template, the approved wording blocks, and the record check sheet. Then use a prompt like this:

Review the blank discharge instruction template against the approved wording blocks and completion map below.

Do not add clinical content. Do not infer missing information. Keep all fields in square brackets unchanged.

Return:
1. A correction list with: section, issue, required action, and whether clinician approval is needed.
2. A list of approved wording blocks that must remain unchanged.
3. A list of unresolved placeholders.

If the completion map says “conflicting” or “needs confirmation”, mark it “CLINICIAN DECISION REQUIRED”.

Read the correction list against your local documents. Resolve administrative omissions, such as a missing contact field or an absent document reference. Leave every clinical conflict for the responsible clinician.

4. Produce the plain-language draft

Once the correction list is accurate, ask for a second output. Use only the corrected blank template and the approved wording blocks. Keep the same placeholders, even where you know the patient-specific answer locally.

Create a plain-language discharge instruction draft from the corrected template.

Rules:
- Preserve the meaning of every approved wording block.
- Keep fixed wording unchanged.
- Keep all square-bracket placeholders exactly as written.
- Use short sentences and clear headings.
- Do not add advice, explanations, timings, contacts, or clinical details that are not in the supplied material.
- Put “CLINICIAN DECISION REQUIRED” beside every unresolved item.

End with a section titled “Clinician check before sending”.

The draft should be easy to scan. It should separate practical actions, contact details, follow-up arrangements, and unresolved items. Do not treat simpler language as permission to weaken required wording.

5. Check the draft where errors matter

Open the draft beside the approved wording sheet and the local patient record. Complete this check in your approved system, not in the model.

If you see this	Do this
A placeholder has been removed	Restore it and mark it for local completion
A sentence adds a reason, timeframe, or instruction	Remove it unless it appears in approved wording or is confirmed by the clinician
Fixed wording has changed	Replace it with the approved block
Two local sources do not agree	Stop and obtain a clinician decision
The draft is hard to read aloud	Simplify the sentence, without changing its approved meaning

Check particularly for dropped negatives, changed quantities, altered timing, and substituted contact routes. These are small wording changes that can materially change what a reader understands.

6. Assemble the clinician-ready document

Copy the checked plain-language draft into the approved discharge document locally. Fill each placeholder from the patient record under your organisation's normal access controls. Retain visible markers for every unresolved item.

Place these items at the end of the document for the responsible clinician:

• the correction list, with completed items marked;
• every CLINICIAN DECISION REQUIRED item;
• a note of any fixed wording that was retained unchanged;
• the final discharge instruction with local fields completed.

The clinician checks the clinical content, resolves conflicts, and approves the document before it is sent. This process produces a reviewable work product, not a clinical decision.

When the process does not work

Stop if the approved wording is unavailable, the record check sheet contains a conflict, or the output supplies details that were not provided. Return to the blank template, remove the unsupported text, and ask the responsible clinician which wording or field value should be used.

If the model repeatedly changes fixed text, reduce the input to one section at a time and label the fixed block clearly. If the draft remains confusing, keep the approved wording and ask for a layout change only, such as headings, shorter paragraphs, or a clearer order. Do not use the model to settle a clinical ambiguity.