You've been in the hospital, and now it's almost time to go home. Before you are discharged, you and your caregiver will need to do some planning. You want to ease the move from the hospital to your home. Your doctor and the hospital staff will help you prepare.
The checklists and charts available at the bottom of this article can help you make sure you have all the bases covered. Have a caregiver or family member print these out before your discharge day. Perhaps you can fill them out together.
Contact your nurse or case manager (if you have one) so she or he can help coordinate your plans.
Avoid a return trip
You're probably excited to get out of the hospital. You don't want to go back anytime soon. Yet a surprising number of patients face that prospect.
A study tracked more than 11 million Medicare patients after they left the hospital. It showed that one in five were back in the hospital within 30 days. More than a third were readmitted within 90 days.
A readmission can slow down a patient's recovery. It can also lead to other health complications.
Readmitting patients is costly for everyone. To help cut readmissions, the Agency for Healthcare Research and Quality (AHRQ) has launched an effort to help hospitals improve their practices.
"The good news: We know how to prevent many readmissions," says agency director Carolyn Clancy, MD, in a statement. "And we have tools to help hospitals do a better job."
Taking charge of your own care
As the patient, you have a big responsibility for self-care. You need to follow instructions you receive when you go home from the hospital.
For starters, according to the agency, you need to:
- See your doctor as directed.
- Take your medicines as directed.
- Exercise (but only as directed by your doctor).
- Eat healthy foods.
- Know who and when to call with questions or if problems arise.
These tips are part of a patient guide called "Taking Care of Myself: A Guide for When I Leave the Hospital." It talks to the patient in clear and simple language.
The guide gives you charts to fill out so you know when to take your medicines, how much to take and what each one is for.
The guide also has a chart to remind you of your doctor appointments. In the Medicare study, more than half the readmitted patients did not see their doctor between the time they were released and when they were readmitted.
A program was developed at Boston University Medical Center. It found that patients who received instruction on their after-hospital care were less likely to be readmitted. They were also less likely to seek emergency services.
Some successful practices endorsed by the program include:
- Educating patients about their condition while they're in the hospital.
- Making appointments for any necessary follow-up tests or visits.
- Helping patients understand how to take their medications.
- Calling patients a few days after they leave the hospital to check on their progress and address any problems.
More than 260 hospitals are now using steps outlined in the project to prevent readmissions, according to the agency.
Mind your medications
Hospitals are recognizing that one of the top five reasons that people return is because they have problems with their medications, says pharmacist Doug Scheckelhoff. He is vice president of professional development for the American Society of Health System Pharmacists.
Many hospitals now have on-site pharmacies for the convenience of their patients, Scheckelhoff says.
Filling your prescription at the hospital can help ensure that you get on track right away, he says. Sometimes a hospital pharmacy will fill a prescription and have it delivered to the patient's room.
A surprising number of first-time prescriptions never get filled, he says. Sometimes it's due to cost. The patient finds out how much the drug is and won't have it filled. "That's the worst outcome," he says. "It's most likely something you need to be taking."
In those cases, "Your pharmacist can talk to your doctor about a generic drug or another alternative that's less expensive," he says.
Scheckelhoff urges those returning home to talk to their pharmacist or doctor about their medications. Prescriptions may have changed while in the hospital. "They might have had a condition that was treated or cured in the hospital," but they haven't stopped the medication, he says.
Going home: A checklist for you and your caregivers
The checklists and charts at the link below can help you prepare for a successful trip home. If you can't answer these questions, be sure to ask your doctor, nurse, social worker or other hospital staff member for help. Write down their answers and be sure to take that information home with you.
NOTE TO USERS: Clicking on the link below will open a new window in your Internet browser. From that window you may print out your checklists and charts. To return to this article, simply close that window.
Created on 11/04/2009
Updated on 10/22/2012
- Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine. 2009; 360:1418-1428.
- Agency for Healthcare Research and Quality. Helping You Avoid Return Trips to the Hospital.
- Agency for Healthcare Research and Quality. Taking care of myself: A guide for when I leave the hospital.