Top Tips for Avoiding a Return Trip to the Hospital

Nip medication mix-ups in the bud

• Be aware that medication problems are a prime cause of readmissions. People arrive at the hospital with one set of drugs, leave with another, creating room for mix-ups, duplication, confusion and harmful interaction.

• Doctors need to know all the drugs a patient is taking — prescription and over the counter, including vitamins and supplements. A friend or relative might want to go to the patient's home and check medicine cabinets, bedside tables, kitchen counters, purses, drawers, shoe boxes, the fridge.

• Confusion can occur in many ways. One example: A patient can get "a statin" in the hospital and not realize it's similar to the "heart pill" at home. Ditto for blood pressure medicines, antacids and other drugs. Taking both can be dangerous.

• Get clear written and oral instructions about what to take, what not to take, and when and how to take medicines. When doctors contradict one another, insist on clarification. "The most important thing is fine-tuning that medication list. And I don't care if you are Einstein, you need another person with you to ask questions and make sure you understand," says Carol Levine, director of the Families and Health Care Project at the United Hospital Fund in New York.
  

Know whom to call if you don't feel well

• Know the danger signs for your condition and have a plan so that you don't overreact — or underreact. (Sometimes you do need to call 911.) Ask, how can I tell whether there is a real problem? How can I tell whether I am going downhill?
  
  
• Know whom to call, by day and on nights or weekends. "If things seem to be going badly, who do I call? If the answer is 'the ER,' you are already three-quarters of the way to being readmitted," says Stephen Jencks, M.D.
  
  
• Will you need help with transportation to your doctor appointments?
  
  
• Ask what services are available in your community after your discharge. A home visit from a nurse? Telephone monitoring? Classes? These are becoming more common.

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