Home Visit Close-Out Checklist for IBCLCs

Before you park

Confirm the reason for the visit in writingA text from the parent naming the problem, the infant age and the last weight gives you a starting hypothesis. Good looks like knowing before you knock whether this is a supply question, a pain question or a transfer question.
Charge the scale and check its calibrationA scale that dies mid visit or reads two grams off makes the weighted feed useless. Test it against a known weight at the start of every driving day, not once a month.
Pack a disinfected kit and a clean drapeFlanges, syringes, a tube set and the scale tray all move between newborns. Everything that touches a family goes in clean and comes out in a sealed bag for reprocessing.
Settle payment terms before the door opensConfirm cash pay, superbill or in network, and the amount, by text. A family that is surprised by a bill at the door is a family that argues in front of a crying baby.
Open the visit template in the carHave the assessment fields loaded before you walk up. Fumbling for a form on a couch is how history gets recorded from memory two hours later.

The first twenty minutes in the home

Take the birth story and the last twenty four hoursDelivery type, gestational age, any separation, and every feed, void and stool since yesterday. Good looks like a written count, not an impression of how the night went.
Watch a full feed before you touch anythingObserve the latch the family actually uses, in the position they actually use, on the furniture they actually use. Correcting before observing loses you the baseline you need.
Do the oral and maternal assessment in a fixed orderSame sequence every visit so nothing is skipped when a family is distressed. Record findings as observations, and keep interpretation in the plan section where it belongs.
Record maternal symptoms in her own wordsPain descriptions, nipple appearance and any fever belong in the chart as she says them. This is the record that supports a referral if mastitis or a vasospasm picture develops.
Ask permission in writing before any photographImages of an infant mouth or maternal tissue need explicit consent recorded in the note. If consent is not clear, describe the finding in words and do not photograph.

Weighted feed and measurement

Zero the scale on a hard floorA bed or a rug ruins the reading. Set up on tile or hardwood, away from a vent, and let the scale settle before the pre feed weight.
Weigh pre and post feed with identical clothingSame diaper, same blanket, nothing added or removed between weights. Any change in what the baby is wearing turns a transfer number into a guess.
Record transfer in grams, not impressionsWrite the pre weight, the post weight and the difference. Good looks like a number a pediatrician can act on without calling you to ask what you meant.
Compare against discharge weight and the last checkPercent of birth weight regained and grams per day since the previous weight are the two figures that drive urgency. Both belong in the note and in the parent plan.
Measure the flange rather than estimating itIf pumping is part of the plan, measure nipple diameter and record the size you recommended. Guessing a flange size is a common cause of a plan that quietly fails at home.

Plan and close-out at the door

Write the plan while you are still on the couchFeeding intervals with hours attached, supplementation volumes if any, pumping schedule, and the thresholds that mean call now. A plan written later is a plan the family cannot follow tonight.
Send the written plan to the parent before you leaveText or message it while you are still in the driveway and confirm she has it. A plan read aloud in a sleep deprived kitchen is a plan that is gone by the evening feed.
Set the follow up window and name who calls whomState the date for the next weight check and who initiates contact. Ambiguity here is why families drop off at day ten with the problem half solved.
Send the referral or update letter the same dayPediatric offices judge a consultant on turnaround. A short, structured summary with the weight numbers and your recommendation, sent that afternoon, is worth more than any brochure.
Close the charge and hand over the receipt or superbillCollect payment and give the family the document they need for reimbursement, with diagnosis and service codes filled in. Doing this at the door prevents the two week email chase.
Close the note before the next drive startsThe visit is not finished until the record is complete. If your template still has empty fields when you reach the car, fix them there rather than at eleven at night.

How to use it

Run this checklist on your next three visits exactly as written and time yourself. Most consultants find two items that are already automatic, one that has been quietly slipping for months, and one that adds five minutes in the home but removes forty minutes of evening work.

After that, adapt it. A practice that mostly does day three first visits will weight the assessment section more heavily. A practice built on follow up weight checks will lean on the measurement and close-out sections. The one part worth keeping intact is the close-out, because that is the part that protects your evening and your referral relationships at the same time.

Send me the editable copy

Enter your email and we will send the editable copy you can print for the visit bag or keep on your phone.

Questions about this document

Can I use this checklist with my own charting system?

Yes. It is written as a working sequence, not as software instructions, so it maps onto paper, a general chart or LatchDesk equally well. The only requirement is that whatever you use lets you finish the note before you drive away.

Is the close-out realistic on a busy four visit day?

It is, but only if the plan is written in the home rather than after it. Consultants who add ten minutes of close-out inside the visit typically remove thirty to forty minutes of evening charting per family. Try it on one day before deciding.

Does this cover what I need for insurance documentation?

It covers the clinical spine that most payer documentation expects: history, assessment, measured outcome, plan and follow up. It is not a substitute for a specific payer policy, so check the requirements in your own contracts before relying on it for claims.

The close-out is where it slips

Writing the feeding plan on the couch and sending it before you pull out of the driveway is the item most consultants abandon on a four visit day, and doing it from a blank note is why. A demo puts the oral assessment fields, the pre and post feed weights and the parent plan on one screen you can finish before you stand up. Bring a real family from last week and we will run the close-out sequence on it.

Request a LatchDesk demo Email the publisher

The home visit close-out checklist