Preventing hospital readmissions

I’ve said it many times in this blog: Don’t go to the hospital alone! And don’t let your friends or family members go alone, either.

Having or being a patient advocate during a hospitalization can really improve communication among the patient, the patient’s family and the myriad of health care providers in modern hospitals.

Related story from KevinMD: There are too many cooks in the health care kitchen

Better communication is especially important at discharge time, when the doctor and nurses give you lots of instructions about your follow-up plan: Do you have new medications? Did you stop old medications? Do you have any diet or activity restrictions? When do you need to make an appointment for a follow-up visit with the doctor? Which doctor? And so on.

It can get very confusing.

In another post from KevinMD, a physician gives some useful advice to help prevent getting sent back to the hospital:

Understand why you’re in the hospital. This sounds simple, but some patients have multiple health problems. You could be in the hospital for a heart attack, but also see doctors for a lung problem or diabetes or something else. What brought you to the hospital?

If we don’t understand what caused our admission in the first place, how are we to keep ourselves from repeating what may have caused the hospitalization in the first place?

Understand the follow-up directions. Ask questions if you don’t clearly understand! And this is where an extra pair of ears really helps. Which doctor are you supposed to follow up with, and when? Do you need to have a blood test or x-ray or something else first? Be assertive when you make the appointment and don’t let the receptionist put you off until “an appointment is available” in two months.

Studies have shown that almost 50 percent of readmissions occur within a week of discharge.

Understand any medication changes. You’ll be given written instructions, but again having another person read the list and ask questions of the nurse is really helpful. What are the new medications? What is each for? When should they be taken? For how long? Were any medications stopped?

Knowing when to take the medicines and what to expect with both side effects and effectiveness is another hurdle that needs to be overcome in order to remain at home and not re-hospitalized. Even I as a physician am sometimes challenged with health literacy associated with medication management.

Have a home buddy. This is the same as a patient advocate, a friend or family member who can be with you in the hospital and at home to make sure you are getting the care you need.

Having a family member or friend there when the discharge directions are given can be a huge help. It’s a second set of ears, someone that can help to create a “home plan” and someone that can help with things such as transportation to follow-up visits, getting your medications for you and support around the home.

No one can do this all alone.

Amen to that!

Sláinte,

Frugal Nurse

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