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Finding Your Way

How to Avoid the Roundtrip Visit to the Hospital

When patients get out of the hospital, it’s usually a sign that their health is getting better and they’re ready to recover at home. Unfortunately, millions of patients each year end up back in the hospital. In fact, one in five Medicare patients returns within one month of being released. Even more people face unexpected medical problems within weeks of leaving the hospital.

Many of the medical problems that send patients back to the hospital could have been avoided in the first place.

What causes these problems to happen?

Often, patients and caregivers don’t understand what they need to do to take care of themselves or their loved ones after a hospital stay. No one at the hospital told them exactly what they should and shouldn’t do at home or answered questions about taking medicines, making follow-up appointments or arranging for follow-up tests.

Research sponsored by my agency, the Agency for Healthcare Research and Quality (AHRQ), found that more than one-third of the patients who leave the hospital don’t get the follow-up care they need such as lab tests or a referral to see a doctor who specializes in their condition.

The good news is that efforts are being made to make sure that patients—and family members—get and understand the information they need before they leave the hospital.

Educating patients about their medicines before they leave the hospital is a 2010 patient safety goal from the Joint Commission, a national group that accredits hospitals. Medicare has also stopped paying hospitals for added costs that result when certain preventable conditions cause patients to end up back in the hospital.

Recently, AHRQ developed a new guide to get patients better prepared to leave the hospital. “Taking Care of Myself: A Guide for When I Leave the Hospital” is a fill-in-the-blank form that highlights what patients need to know when they leave the hospital. It’s based on pioneering work done at Boston University Medical Center, where doctors and nurses at the facility changed the way patients are discharged from the hospital. There, trained nurses help patients understand their condition, make follow-up appointments and confirm which medicines they should take. A pharmacist also contacts patients two to four days after they leave the hospital to answer any questions they may have about their medicines.

Patients who took part in the program were 30 percent less likely to have a second hospital stay or go to the emergency department than patients who did not participate.

The same simple, but important, steps that help those patients can help you or your loved one. These steps, outlined in the new guide, include:

  •  Making an appointment to see your doctor or a specialist who treats your condition.
  •  Taking your medicines correctly.
  •  Making sure you aren’t allergic to any of your medicines.
  •  Asking your doctor about your test results.
  •  Getting the right kind of exercise.
  •  Knowing whom to call with questions or problems.

Print out this easy-to-understand guide and take it with you when you go to the hospital. Fill it out with the help of your doctors and nurses. It will help you keep track of crucial information and it gives you space to write down any questions you want to ask during future appointments.

Of course, having this guide on hand won’t prevent you from going back to the hospital if you have a bad reaction to a medicine or if you need more treatment. But it does increase the chance that you’ll be better prepared to take care of yourself when you leave the hospital. If you can prevent a return visit you’ll save time, money, and stress—as you continue your recovery.

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

Carolyn M. Clancy, a general internist and researcher, is an expert in engaging consumers in their health care. She is the director of the U.S. Agency for Healthcare Research and Quality.

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