Lesson's Learned from Readmissions

Julie Shenkman
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When Medicare penalized hospitals for high readmission rates under the Affordable Care Act, the controversy shed light on avoidable gaps in patient care. Many patients return to hospitals within a month because they don't receive adequate care coordination before and after discharge. As a result, nationwide health providers implemented strategies that reduced hospital readmissions by 8 percent from 2010 to 2015. Learn from reduction strategies to improve your hospital stays and avoid unnecessary return trips.

Have Productive Conversations With Health Providers

Clinicians aren't solely responsible for care coordination, as they have limited means of monitoring your condition once you return home. Communicating with doctors is intimidating for many patients, and they don't spend enough time discussing their options or the pros and cons of different treatments. Patients and families have to take an active role in care coordination, making it vital to ask questions and address all concerns during the hospital stay.

Health providers want you to speak up about health concerns, as it helps them guide you to solutions best suited to your needs. Understand that you have a voice and it's not confrontational to have questions. Take notes, or ask for printouts about any treatments you discuss, giving yourself time to thoroughly review and process new information without feeling pressured.

Get a Detailed Discharge Summary

Hospital clinicians usually provide a verbal and written summary describing your health complaint, symptoms, diagnostic findings, and techniques or medications administered to you. The problem is that hospital jargon is twice as confusing when you're physically and emotionally stressed. Ask for a summary written in easy-to-understand terms, and make sure the discharge instructions are clear about what you should and shouldn't do after leaving.

When possible, have family members who are involved in your care coordination present at major discussions to keep all caregivers on the same page. Get recommendations for a follow-up plan and a list of contacts, so you don't miss important touchpoints to monitor the progress of your recovery.

Understand Postdischarge Risks

Many hospital readmissions happen because patients believe they can immediately jump back into a normal routine. Recovery takes time, and patients are often vulnerable to new problems or injuries during this high-risk period. To ease recovery, clinicians recommend visiting a primary care provider within a week of discharge, especially if you're managing multiple chronic conditions.

PCPs have a more complete understanding of your health history and can offer tailored guidance on minimizing risks while rebuilding your health. In most cases, PCPs also oversee care coordination between specialists to improve consistency and prevent conflicting treatment recommendations.

Discuss Medication Schedules and Risks

Pairing medications incorrectly or taking them inconsistently can worsen your health problems and create new ones. Unfortunately, many patients go home with a handful of prescriptions and no idea why they matter. Ask hospital staff to explain exactly what each prescribed medication does and common risks associated with them. Be sure to find out which medications must be taken at certain times and with or without meals. Take advantage of programs that let you fill prescriptions at the hospital, making it easier to start medication right after discharge.

Effective care coordination is the key to avoiding high readmission rates. The more informed you are about health issues, the more you increase your chances of a successful recovery.

Photo courtesy of Vic at Flickr.com


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