Preventing Hospital Readmissions

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Spending time in a hospital is not, typically, a joyous occasion for patients, especially those who are aging. Not only is the terror of a potential life-or-death situation looming, but studies show that patients heal better and live longer with in-home care as opposed to a hospital stay. There is a huge emotional toll with a hospital visit, one that can fill loved ones and the patient with dread.

The price tag of a hospital stay is also noteworthy. In addition to the initial costs, one of five Medicare recipients is readmitted to the hospital within thirty days of being released. Ninety days after release, some thirty-four percent of all Medicare recipients undergo readmission.

Canadian researchers have found that seniors are most likely the ones revisiting a hospital after discharge. Thus it is important for caregivers and seniors to know how to prevent readmissions.

Follow Medical Instructions

Doctors work many, many hours for patients. Emergency room doctors, especially,often work odd hours and exhausting shifts. Doctors therefore do not give orders for treatment lightly. They want their treatments to be effective. Thus, if the doctor calls for a change in dosage of a certain medication, orders physical therapy, or suggests any other kind of treatment, patients and/or their caregivers should follow orders diligently, reading instructions carefully and asking any questions necessary for clarity. Taking notes is recommended. Having the doctor’s contact information available in case of further questions, and delivering the instructions to the patient’s primary care physician are also advisable.

Attend All Follow-Up Visits

Follow-up appointments are important but sometimes difficult to manage. The caregiver can make sure that someone is available to transport the senior to any follow-up appointments and help hold that transportation accountable. Making appointments with the senior’s calendar in mind can also help, since schedule conflicts interfere with keepingappointments.

Follow-up visits are a chance to report any complications, check medication regimens, and spot problems before they require serious treatment in the form of a return hospital stay. Communication is key; the patient should be honest about any symptoms or reactions. Instructions from every doctor the patient has should be accessible, and the patient and/or caregiver should be prepared to receive and implement new instructions as well.

Keep an Eye on Preventive Measures

Preventing future complications is a good subject for conversation with the doctor. The patient and/or caregiver should also do reading and research about what is available at home to help prevent hospital readmission.

For example, many seniors go to the hospital after a fall. Preventing falls at home includes general tidiness and non-slide shoes for the senior.

Diabetic complications account for many hospital stays, but the odds are that careful management of blood glucose will help prevent further complications. A lack of complications means a lack of return trips to the hospital, more time at home, and a longer, healthier life.

Bring in More Experts

Evern professonal caregivers find it hard to keep up with new medicines, new studies, and new methods of treatment. By consulting with other experts, such as visiting nurses, pharmacists, and other hospital staff, the caregiver can work as a team member to coordinate care during the transition from hospital to home. Lack of communication between various doctors and caregivers is often a cause of hospital readmissions, so facilitating and maintaining communication is a huge step toward preventing another hospital visit.

Sources

Brennan, Niall. Real-Time Reporting of Medicare Readmissions Data. Findings from Recent CMS Research on Medicare. Centers for Medicare and Medicaid Services. Available at https://kaiserhealthnews.files.wordpress.com/2014/10/brennan.pdf. Retrieved March 22, 2016.

Forster, A.J., Clark, H. D., Menard, A., Dupuis, N., Chernish, R., Chandok, N., Khan, A., and van Walraven, C. (March 2, 2004). Adverse events among medical patients after discharge from hospital.Canadian Medical Association Journal (CMAJ), 170(3): 345-9. Available at http://www.ncbi.nlm.nih.gov/pubmed/14757670. Retrieved March 22, 2016.

Forster, A.J., Murff, Harvey J., Peterson, Josh F., Gandhi, Tejal K., and Bates, David W. (February 4, 2003). The Incidence and Severity of Adverse Events Affecting Patients after Discharge from Hospital. Annals of Internal Medicine, 138(3):161-167. Available at http://annals.org/article.aspx?articleid=716006. Retrieved on March 22, 2016.

Jencks, Stephen F., Williams, Mark V., and Coleman, Eric A. (April 2, 2009). Rehospitalizations among Patients in the Medicare Fee-for-Service Program. New England Journal of Medicine, 360:1418-1428. Available at http://www.nejm.org/doi/full/10.1056/NEJMsa0803563?siteid=nejm&keytype=ref&ijkey=3CQjS3yxXjOtY&. Retrieved on March 22, 2016.

Khullar, Dhruv. (March 17, 2016). Most Dangerous Time at the Hospital? It May Be When You Leave. The New York Times. Available at http://well.blogs.nytimes.com/2016/03/17/most-dangerous-time-at-the-hospital-it-may-be-when-you-leave/?_r=1. Retrieved March 22, 2016.

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