Be aware that all unplanned, rushed or poorly coordinated discharges from hospitals are very dangerous! A recent study in the New England Journal of Medicine concluded that one in five Medicare patients are readmitted to the hospital within 30 days. One in three are back within 90 days. The author suggests that many of these problems are related to inadequate coordination of care and poor discharge planning.
Why This Happens
Discharge planning is not always given the care and attention necessary for a smooth transition from the hospital. All patients should receive detailed care instructions in their language and at their health care literacy level. Unfortunately, this does not always happen.
Hospital staff members are under intense pressure to release you as soon as they can. Those in the health care industry have coined the term “quicker and sicker” when they describe how patients are now discharged from hospitals. As a direct result of such early hospital discharges:
· 41% of patients are discharged with test results still pending.
· 13% of these tests are of an urgent nature.
What’s worse, at the time of discharge, one half of adults have trouble understanding their prescriptions or discharge instructions. In addition, less than one-half of patients know their diagnosis, treatment plan or side effects of prescribed medication.
The results of poor care coordination at the time of a hospital discharge can jeopardize your health and safety. Here is my recommendation; don’t allow this to happen to you or a loved one.
Take Active Role in Your Discharge Plan
You must insist on a well planned and coordinated hospital discharge plan. At the very least, be sure to:
1. Receive the necessary discharge education about the condition that brought you to the hospital. Take full advantage of the expertise of the hospital staff. Ask as many questions as necessary to gain a full understanding of your condition, diagnosis, and treatment plan. Ask for written information as well.
2. Request to meet with the hospital pharmacist to review all of your discharge medications. Be sure to discuss any changes, additions or deletions of medication that you were taking before your hospitalization. This process is called “Medication Reconciliation” and is essential to a safe discharge. It has been found that between 20 and 30% of all hospital re-admissions within 30 days are the direct result of medication issues.
3. Find out when you need to follow up with your medical team such as your primary care physician, surgeon or specialist. This is critical as a well coordinated discharge plan will involve timely follow up care.
4. Be sure that your primary care physician receives copies of your discharge medication list and instructions. Take your copy with you to your follow up appointment.
These are just a few of the items that need to be contained in your official discharge plan. Remember, this may not happen unless you request it. You will increase the likelihood of a safe discharge when you are an active participant in discharge planning.