Writing a Discharge Summary with AI

The Problem

Discharge summaries take 15–20 minutes per patient on average — often more for complex admissions. That’s time taken from patient care, teaching, or rest. AI can reliably cut this to under 5 minutes while improving consistency and completeness.

This workflow walks you through a repeatable 3-step process for drafting discharge summaries using Claude or a similar LLM.

Step 1: Gather Your Inputs

Before prompting the AI, collect the key clinical information you’ll need:

• Admission diagnosis and reason for visit
• Hospital course (brief narrative of what happened)
• Key studies (labs, imaging, procedures)
• Medications changed (started, stopped, dose-adjusted)
• Discharge condition (stable, improved, etc.)
• Follow-up instructions (appointments, pending results, return precautions)

Having these organized before you prompt will dramatically improve output quality. A messy input yields a messy output.

Step 2: Use the Prompt Template

Use the template below with Claude. Paste in your de-identified clinical notes or a structured summary of the above points.

You are an experienced hospitalist physician writing a discharge summary. Using the clinical information below, draft a complete, concise discharge summary suitable for the outpatient primary care provider.
Format the summary with the following sections:

Admission Diagnosis
Hospital Course
Significant Results
Discharge Medications (changes only — started, stopped, dose-changed)
Discharge Condition
Follow-up Instructions
Return Precautions
Be concise and clinically precise. Avoid filler phrases. Use plain language for the follow-up section.
CLINICAL INFORMATION:
[Paste your de-identified clinical notes here]

Step 3: Review and Edit

The AI output is a first draft, not a final product. Always:

1. Verify medication accuracy — this is the highest-risk section
2. Check that pending results are documented and follow-up is assigned
3. Ensure the hospital course narrative is complete and accurate
4. Remove any fabricated information (hallucinations are rare but possible)
5. Sign and co-sign per your institution’s requirements

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