Background: Self-directed discharge, also known as Against Medical Advice (AMA) discharges, comprise 1–2% of hospital discharges (1). The AMA process poses safety risks to patients and emotional strain on providers, potentially leading to implicit biases in documentation (2). While stigmatizing language in medical records has gained attention (3), its prevalence in AMA documentation remains underexplored. [...]

Background: Self-directed discharges, also referred to as discharge “against medical advice” (AMA), refer to when patients leave the hospital prior to medical readiness. These discharges lead to worse health outcomes for patients, ethical dilemmas for clinicians, and increased readmission rates affecting healthcare systems. Research on self-directed discharges has emphasized patient characteristics affecting discharge, with less [...]

Background: Self-directed discharges, also referred to as discharge “against medical advice” (AMA), comprise 1–2% of hospital discharges. Practice guidelines suggest avoiding the designation of “AMA” discharge as this is associated with adverse outcomes. The term “AMA discharge” persists, however, and characteristics of clinician documentation of self-directed discharges remain underexplored. We used retrospective chart review at [...]