Discharge Advocate's Data Collection Tool

Project RED (Re-Engineered Discharge) Training Program

The Discharge Advocate (DA) can use this form to note dates and times for the activities listed in the left column. Once it is complete, it should be sent to the project team leader for data entry.

Data To Collect	Patient 1	Patient 2	Patient 3	Patient 4
Data To Collect
Patient Name
Patient Location
Date and Time of Admission
Date and Time DA Notified
Patient Meets All Inclusion Criteria?	___ Yes ___ No	___ Yes ___ No	___ Yes ___ No	___ Yes ___ No
Date and Time of Initial DA Visit With Patient
Date(s) and Time(s) of Daily DA Visits With Patient (Note All)










Date and Time of Discharge
Date and Time Care Plan Faxed to Primary Care Physician
Date(s) and Time(s) of Post-Discharge Call (Note All)

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Page last reviewed August 2011

Internet Citation: Discharge Advocate's Data Collection Tool: Project RED (Re-Engineered Discharge) Training Program. August 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/professionals/systems/hospital/red/datatool.html