Ayurveda Inpatient Discharge Summary

Patient: [Full name], [DOB], [MRN], [Sex/gender]

Facility/Service: [Facility name], [Unit/service]

Admission: [Date and time]

Discharge: [Date and time]

Attending Physician: [Name and contact]

Disposition: [home / home with services / transfer to specified destination / AMA / other]; [Condition at discharge]

Allergies: [Drug, food, and herb/formulation allergies with reaction type] (If none documented, state "No known allergies.")

Reason for Hospitalization

[Chief concern, key presenting symptoms with severity, precipitating factors, and relevant high-risk comorbidities that influenced management] (3–5 sentences. If admitting diagnoses differ substantially from discharge diagnoses, note the discrepancy.)

Discharge Diagnoses

(List in order of clinical priority. Use standardized Ayurveda terminology. Label uncertain diagnoses as "suspected" or "possible.")

• Ayurvedic: [Roga with plain-language gloss]; Biomedical: [Diagnosis or "Not applicable"]
• Ayurvedic: [Additional diagnosis with gloss]; Biomedical: [Diagnosis]
• Active comorbidities: [Conditions relevant to medication safety or follow-up]

Hospital Course

(Organize by problem, highest-risk first. Repeat the block below for each active problem.)

[Problem name]: [Ayurvedic term] — [Biomedical term]

• Assessment: [Key findings and clinical reasoning] (Summarize pertinent exam, labs, and imaging driving decisions.)
• Interventions: [Medications, Ayurveda therapies, procedures, supportive care with names, doses, routes, frequencies, and dates]
• Response: [Symptom trajectory, objective changes, adverse effects if any]
• Discharge plan for this problem: [Ongoing treatment, monitoring needs, follow-up owner]
• Consultations: [Consultant/service and key recommendations] (Only include if consultation occurred for this problem.)

Complications: [Inpatient complications, adverse events, or procedure-related issues] (If none, state "No inpatient complications.")

Procedures and Ayurveda Therapies

(If none performed, state "No procedures performed.")

• Biomedical procedure: [Procedure name], [Date]. Indication: [Indication]. Operator: [Name/role]. Findings: [Key findings]. Complications: [None / description].
• Ayurveda therapy: [Therapy name (standardized)]. Dates/Sessions: [Frequency and total]. Indication: [Target problem]. Materials: [Oils, decoctions, ghee, etc.]. Tolerance: [Well tolerated / adverse effects]. Post-therapy care: [Recovery instructions].
• Supportive therapies: [Yoga therapy / physiotherapy / dietary therapy] with [focus and response]. (Include only if performed.)

Discharge Medications

Reconciliation Summary:

• Continue: [Medications unchanged from pre-admission]
• Stop: [Discontinued medications with rationale for high-risk items]
• New: [New medications with rationale]
• Changed: [Medications with dose/schedule changes and rationale if safety-relevant]

Discharge Medication List:

• [Medication/formulation name]: [Dose], [route], [frequency], [duration/stop date]. Indication: [Plain-language purpose]. Administration: [Timing, food requirements, anupana/vehicle for Ayurveda formulations]. Monitoring: [Key parameters and serious adverse effects requiring action]. (For non-formulary Ayurveda formulations, include manufacturer and interaction cautions with anticoagulants, antiplatelets, hypoglycemics, sedatives.)
• [PRN medication]: [Dose], [route], PRN for [indication]. Max daily: [Maximum dose]. Seek help if: [Frequent use needed or inadequate relief].

Pending Results and Follow-up Monitoring

(If no pending tests, state "No pending results.")

• Pending: [Test name], obtained [date]. Reviewer: [Name/service]. Patient notification: [Method and expected timeframe].
• Recommended test: [Test name]. Reason: [Why needed]. Timeframe: [When]. Responsible to order: [Who].

Follow-Up Plan

• [Clinician or service]: [Purpose/problem being addressed]. When: [Scheduled date or target timeframe]. Location: [Clinic/telehealth details]. Preparation: [Fasting labs, bring medications, etc.]

Return precautions: [Condition-specific warning signs with timeframes and action steps; clinic contact number and after-hours instructions]

Care coordination: [Home services, equipment, caregiver training, access barriers] (Include only if applicable. If information unavailable but needed, state "Not documented" with mitigation steps.)

Attestation

Author: [Name], [Role], [Date/time]

Attending verification: [Cosignature if required by policy]

Distribution: [PCP, specialists, receiving facility as applicable]