Beverly Bernstein Joie

BY:  Beverly Bernstein Joie, MS, CMC
President Elder Connections

Elderly and hospital care

Medical Revolving Doors

It is often said that hospitals can be dangerous to our health!  Actually, according to The Institute of Medicine report, between 44,000 and 98,000 hospitalized Americans die each year as a result of preventable medical errors. Certainly, there are circumstances that demand hospitalization and a hospital visit can be a life saving and necessary event.  But, the problem of remaining at home after discharge has become a hot issue.  Many elderly people with chronic conditions find the move from home to hospital to rehab reminiscent of a revolving door.  Actually, avoidable hospital readmissions affect one in five patients and account for $17.4 billion of the current $102.6 billion Medicare budget.

Recently, Elder Connections was invited to provide an inservice training at the Montgomery Rehab Center to discuss this alarming statistic and share solutions with the staff.  On November 3, 2010, we will be presenting: Tips For Stopping The Revolving Door of Hospital (and Rehab) Readmittance.  Hospitals and Rehab centers are paying increasing attention to this phenomenon due to the Patient Protection and Affordable Care Act .  Starting in 2013, hospitals with “excess” readmissions will incur financial penalties based upon their rates of readmittance.  It’s no wonder that this problem is high on their list of concerns.

What can we do to keep ourselves and loved ones from being readmitted?

Tips To Avoid Rehospitalizations:

Maintain a Personal Health record.  This record is something all of us should maintain and take with us to all doctor’s appointments but especially relevant for hospital discharge purposes.  It should contain your personal information, primary physician information and directions about contacting caregivers and family members.  You should also place into this folder, all your recent hospitalization information, the reason for this hospitalization, copies of tests, medical records, and doctor’s notes.  Most importantly, record the “red flags” and those potential difficulties that will demand immediate doctor contact.  Also, record your concerns and questions in a clear concise way to have on hand when you meet with your doctor following the hospitalization

Discharge Preparation Checklist.  Speak to the doctors, nurses, and social workers about what is going to happen next and be clear about their expectations.  Find out who to call for problems with your transfer, and understand your medications.  Make sure your questions are answered before you leave, your family and/or caregivers are in place and understand your needs, and that a follow-up appointment is scheduled along with the transportation to that appointment.

Medication One of the most important factors to staying away from readmissions is how well you know and understand your new medication regimen.  Invariable medications change during a hospitalization.  Make sure you write them down and take this list with you to every appointment.  Update this list as it changes.  Share all questions and concerns about medications with your doctor. 

 Successful Hospital and Rehabilitation Discharges

 The new health care changes on the horizon has created a call to action.  Some hospitals such as The University of Pennsylvania have utilized a new breed of Physician-Administrator, called a Hospitalist, one of the fastest growing medical specialties.  This specialist is now following the care of patients through their hospitalization to discharge to address this need.  For those being discharged, the family’s participation is critical.  Luckily for families who do not live close by,  the services of a Geriatric Care Manager can be obtained to implement a success discharge plan and follow-through.