Picture this… you end up in the hospital and you can’t wait to get home. Did you know that being discharged from a hospital can be one of the most challenging issues patients face each day?
There are approximately 35 million hospital patients discharged from hospitals each year. Research also proves that hospital discharges are one of the most dangerous times for patients.
Why is the discharge process potentially so dangerous?
Getting discharged from a hospital can feel hurried with little time to coordinate treatment changes and new medications. These hurried transitions are associated with a poor understanding of what needs to be done when the patient arrives home and confusion over what medications need to be taken and how to take them.
As I have mentioned in the past, I spent many years of my career as a physician assistant working with aging seniors. I was often on the post-hospital discharge and the receiving end of admitting new patients to sub-acute rehab in a nursing home.
Many times patients were transferred to the facility after a challenging hospitalization with multiple medical problems. The patients would often arrive by ambulance without any family members. On a good day, I would get a comprehensive discharge summary with a list of the patient’s diagnosis’, medications, and necessary treatments.
Unfortunately, there weren’t many good days! Typically I needed to call the hospital and attempt to piece together what happened to the patient at the hospital and to make sure I got an up-to-date list of medications.
Many patients are discharged directly to their homes and don’t have the benefit of another medical provider double-checking their continuing care, including, receiving their complete list of medications and making sure they are getting all of the necessary post-hospital treatments.
At the time of discharge from the hospital, the patient’s home medication routine may be disrupted. They may have some outstanding laboratory tests and require immediate follow up involving their private physician.
What if an important medication was not restarted? What if the patient cancels their follow up appointment?
It comes as no surprise that 20% of patients receiving Medicare are readmitted back to the hospital within 30 days, often with preventable complications that resulted from a rushed and incomplete discharge plan.
Here are some tips on how to avoid the dangers of being discharged from a hospital:
Bring a copy of all your home medications to the hospital at the time of admission.
At discharge make sure you understand your new medication routine. Ask about your pre-admission medications and if you should restart your previous home medications. If not, ask why.
Have a family member, friend, or caregiver with you at the time you are being given discharge instructions
Ask what type of help you will need when you get home. Do you need a home health nursing visit, physical therapy, or occupational therapy?
If you live alone, are you capable of managing independently? If not, do you need extra non-medical providers in your home or do you need to transition to a sub-acute rehab facility until you are more independent?
Make sure you understand when you need a follow-up appointment with your primary care provider and specialists.
Think ahead. The best time to plan for discharge is often at the time of admission. Give some thought about whether you have someone to help you at home. Can you still climb steps? Will you need special equipment? Can you still drive?
If your family members live out of the area, consider hiring a care manager or health advocate to coordinate your discharge planning.
Being discharged from a hospital is a hopeful sign you are on the road to recovery but it does require some planning to make sure you avoid the pitfalls of the discharge process. At Severino Health Advisors we can help you with these plans and even assist with your aftercare planning. Next, we’ll look at discharge options for patients that are not well enough to return directly to their homes.
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