Implementation of a discharge bundle checklist to standardize the discharge process in inpatient hematology/oncology.

589 Background: Discharging inpatient hematology/oncology patients is complex and requires multidisciplinary coordination with the primary team and other subspecialists. Without a standardized method of information transfer, patient care can be adversely affected. Inconsistent documentation and variability in education contribute to patient confusion, improper medication use, and preventable ED visits. Among internal medicine residents surveyed, 58% were involved with inpatient oncology care at least monthly, 23% weekly, 13% rarely, and 6% daily. Residents identified patient education, medication management, and follow up coordination as areas needing improvement in their oncology training. We implemented a discharge checklist (Oncology Discharge Bundle) in the electronic health record to standardize communication and improve provider confidence in key discharge domains. Methods: A discharge AutoText was developed in Cerner to include structured information on follow-up care, antimicrobial prophylaxis, antiemetic regimens, and GCSF use. All inpatient Hematology/Oncology discharges from December 2024 through May 2025 were encouraged to include this template. We evaluated provider confidence using anonymous pre- and post-intervention surveys with binary yes/no response options among residents. The primary outcome was change in the percentage of respondents reporting confidence in key oncology discharge domains. Results: The survey included 29 pre- and 29 post-intervention responses. Confidence improved across all domains. For example, confidence in knowing which patients require antimicrobial prophylaxis increased from 13.8% to 58.6%, and confidence in identifying appropriate antimicrobials rose from 13.8% to 51.7%. Comfort with discharging oncology patients improved from 44.8% to 65.5%. Confidence in counseling patients and in provider perception of patients’ understanding of their care also improved. Conclusions: Integrating a standardized discharge bundle into the EHR improved provider confidence in multiple aspects of oncology patient discharge. These results support the use of standardized tools to improve discharge safety. Future work will evaluate the impact on patient outcomes, including ED visits and 30-day readmissions unrelated to scheduled inpatient cancer directed therapy. Pre- and post-intervention confidence survey results. Question Pre (%) Post (%) Comfortable discharging an oncology patient 44.8 65.5 Confident identifying patients needing antimicrobial prophylaxis 13.8 58.6 Confident in antimicrobial agents 13.8 51.7 Confident in antiemetic regimen 44.8 62.1 Confident identifying patients needing GCSF 6.9 37.9 Confident in counseling on antimicrobial, antiemetics, GCSF 5.1 44.8 Confident in the patient’s knowledge of their oncology care 55.2 72.4