Hospital Readmissions, or "Bouncebacks", May Be Preventible
A 2009 study published in the New England Journal of Medicine analyzed almost 12 million Medicare beneficiaries and found that approximately one-fifth were readmitted within 30 days of discharge and an even more alarming 34 percent were admitted in 90 days. This is what is referred to as a “bounceback” - a patient who returns to the hospital soon after being discharged. Reasons for bouncing back include problems like uncontrolled pain after a procedure, a surgical infection, or unexpected deterioration of the original reason for admission, such as heart failure.
The study points out that care coordination by the hospital, allied health care professionals, and caregivers are key to keeping people from returning to the hospital. Follow through of post-discharge care procedures must be communicated and carried out.
A recent report by the Robert Wood Johnson Foundation, confirmed similar findings. Of the patients interviewed, many felt that they may not have completely understood their discharge instructions. The ordinary 10-15 minutes of care instruction and pamphlets about their illness were not enough to communicate the need for ongoing care. On the other hand, the patients who saw a nutritionist, a physical therapist, had more time with a nurse or doctor prior to discharge, or coordinated a care plan with a private home care company seemed to have better outcomes.
Although patients said having a family member or other caregiver present during discharge made a big difference to them, they also said they wish they had been more aggressive in asking questions and pushing for details they clearly needed once home.
Those who lived alone had increased challenges. The study reports that a number of the male patients who were alone after their discharge skipped meals or relied on fast food. They did not leave their homes. They had no one around to watch for fever or labored breathing, and no one was there to contact their doctors as their health declined. Some faced transportation issues as well.
Many reports show that simple interventions, such as post-discharge phone calls from pharmacists or the use of a home care transition team, may help with the continuity of care through care-setting transitions. This may lead to impressive improvements in maintaining healthy recovery and decreased hospital re-admissions.
Ezra Home Care understands the importance of proper communication and through follow-through of discharge instructions. We are committed to assisting every client to recover safely and successfully after their surgical procedure or acute hospitalization. We provide an experienced and reliable team of professionals to ensure a safe, successful transition and continued recovery.
Our team will communicate and collaborate with VNA's, doctors and/or hospital/rehab discharge planners to discuss each client's specific care needs, review current medication lists, and confirm follow-up appointments. Structured "hand-off" communication between the professionals involved ultimately improves the quality of care clients receive and may avoid unnecessary re-hospitalization.
Planning ahead for needs such as transportation to and from surgery and follow-up appointments, prescription and equipment pickup and coordinating care at home for at least the first 24-hours after discharge is imperative. Ezra Home Care is available to provide the support needed.
Learn more about Ezra Home Care Post-Surgical Program.
A Place for Mom
The Robert Woods Johnson Foundation
The Bounce Back Effect
Hospital Bounce Back Readmissions
The Bounceback Problem - Slate.com