Hospital Stay Record

Who this is for

One sheet for one stay in hospital. The top carries the admission and discharge dates, the ward and the consultant; the tables underneath record what happened on which day, what you were sent home with as written on the discharge letter, and every follow-up that was mentioned before you left.

Patients and the relatives sitting beside them, carers collecting somebody who is being discharged, and anyone who has left a ward with a folder of paper and no idea which parts of it matter.

What this helps you track

• Admission and discharge dates, ward and consultant in one place
• What happened on each day of the stay, and who said it
• Procedures, scans and tests done while you were in
• Medicines listed on the discharge letter, copied word for word
• Every follow-up mentioned, and whether it has actually been booked

How to use it

1. Fill in the top of the sheet on the day of admission, including the ward and the consultant's name — both can change during a stay, so note it when they do.
2. Add a line each day: what was done, who saw you and what you were told.
3. Before you leave, copy the discharge medicines from the discharge letter exactly as printed, including anything that has been stopped.
4. Write down every follow-up that is mentioned — clinic, scan, district nurse, blood test — with who arranges it.
5. Tick each follow-up once it is actually booked, and chase the ones still untouched a week later.
6. Keep the sheet with the discharge letter, or fill it in online and save it in your own browser.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does this replace the discharge letter?

No, and it should never be used instead of one. The discharge letter is the document your practice works from. This sheet is your own account of the stay, and the place to note the things that were said aloud but never written down.

Why record what I was told each day?

Because a week on a ward blurs, several people say several things, and the detail that turns out to matter is usually the one nobody wrote down. A dated line with a name attached is worth a great deal afterwards.

What goes in the discharge medicines table?

Whatever the discharge letter lists, copied exactly as it appears there. The sheet supplies no amounts, no timings and no explanation of what anything is for.

Can I use one sheet for a readmission?

Start a new sheet for each stay so the dates stay clean, and keep them together. A run of separate sheets shows the pattern of admissions better than one long one.