Table 2.

Description of core components of the patient-centered discharge toolkit. Patient-facing Patient Safety Learning Laboratory (PSLL) tools: patient portal and bedside display; clinician-facing PSLL tools: bedside display and safety dashboard.

Component	Description
EDDa display	Current EDD from the EHRb was visible to patients on the patient portal and bedside display, and to clinicians on the bedside display and safety dashboard (Figure 1, green circles)
Discharge video	Patients could choose to watch a Web-based video of a clinician talking through each checklist item at an appropriate health literacy level Embedded via a hyperlink into the patient portal and REDCap (Research Electronic Data Capture, Nashville, TN) survey Available in English (clinician) and Spanish (medical interpreter)
Discharge checklist	A 16-item checklist that was available in English or Spanish could be completed by patient or caregiver via the patient portal or REDCap survey on a mobile device approximately 24 to 48 hours before EDD Dichotomous responses were sent to EHR-integrated safety dashboard in real time via APIc
Clinician dashboard discharge column	Green flags identified patients with an EDD more than 1 day from the current date Yellow flags identified patients with an EDD less than 1 day from or equal to the current date Red flags identified patients with an EDD that was either not entered or past the current date; for patient portal enrollees, indicated that a checklist had not been completed when the current date was within 1 day of the EDD Checklist icon identified patients who had completed checklist and were awaiting clinician review No or unsure responses to checklist items were displayed by domain; free-text entries were displayed as additional patient-reported concerns; clinicians could address any unsatisfied item as needed (eg, unable to pay for medication and patient unaware of follow-up) Displayed key data from the EHR (medical and nonmedical barriers to discharge, discharge destination, and transportation) A link to initiate secure messaging was displayed for patients who requested postdischarge messaging
Secure messaging postdischarge	A secure messaging thread was opened by a clinician (opt-in process) via a link in safety dashboard (Figure 1, red dashed box) Patients were invited by their discharging clinician (attending, senior resident) to communicate up to 7 days on receiving an SMS text with a hyperlink to a mobile-optimized messaging portal Clinicians messaged with the patient via a HIPAAd-compliant app (Imprivata Cortext) on their mobile phone (without giving the patient access to their mobile phone number)

^aEDD: expected discharge date.

^bEHR: electronic health record.

^cAPI: application programming interface.

^dHIPAA: Health Insurance Portability and Accountability Act.