Discharge Confusion -- Very Serious, Very Sad

[Harrison]

Medicare may penalize hospitals that readmit too many patients

Medicare may penalize hospitals that readmit too many patients - The Washington Post

Excerpt from the article, below.
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Multiple breakdowns

Researchers looking at this trend are discovering that breakdowns occur on multiple levels. The most critical failure seems to be in the discharge process, when the hospital should be preparing a patient for release. Instead, says Brian Jack, a family physician at Boston University Medical Center, the process is often a “perfect storm” of errors that begin even before a departing patient has reached the parking lot.

Many patients leave the hospital without understanding much about their diagnosis or how to handle their condition at home, including what medications to take, says Clancy.

Poor coordination of care and poor transitions in a fragmented system is how Jesse Pines, director of the Center for Health Care Quality at the George Washington University School of Public Health and Health Services describes it.

Proper post-hospital care involves many complicated steps. There are medication routines, follow-up sessions with doctors or physical therapists, adjustments to diet and lifestyle, even knowing what number to call if there’s a problem or a question. It can be very difficult to manage all this, especially if a patient has no caregiver at home or is in a weakened state upon release.

Many hospitals put instructions in writing, handing departing patients a “discharge summary” of steps they need to follow at home. But that summary can be difficult to read or understand; often it is handwritten and filled with jargon. And putting a discharge summary together is not always a doctor’s highest priority. The task often falls to others — nurses or medical residents — who rarely have the time to make sure the patients understand the plan for follow-up care.