Tips to help avoid a preventable hospital return

Michael Lee knew he was still in bad shape when he left the hospital five days after emergency heart surgery. But he was so eager to escape the constant prodding and the roommate's loud TV that he tuned out the nurses' care instructions.

"I was really tired of Jerry Springer," the New York man says ruefully. "I was so anxious to get out that it sort of overrode everything else that was going on around me."

He's far from alone: Missing out on critical information about what to do at home to get better is one of the main risks for preventable rehospitalizations.

"There couldn't be a worse time, a less receptive time, to offer people information than the 11 minutes before they leave the building," said readmissions expert Dr. Eric Coleman of the University of Colorado in Denver.

Hospital readmissions are miserable for patients, and a huge cost -- more than $17 billion a year in avoidable Medicare bills alone -- for a nation struggling with the price of health care.

Now, with Medicare fining facilities that don't reduce readmissions enough, the nation is at a crossroads as hospitals begin to take action.

"Patients leave the hospital not necessarily when they're well but when they're on the road to recovery," said Dr. David Goodman, who led a new study from the Dartmouth Atlas of Health Care that shows different parts of the country do a better job at keeping those people at home.

And The Associated Press, teamed with the Robert Wood Johnson Foundation, found hospitals are hunting innovative ways to fix a key hole in this health care: Those missed instructions.

Here are tips to improve your chances of a successful recovery at home:

  • Be sure you understand your illness and the care you received in the hospital.
  • Ask if you will require help at home. Can you bathe yourself? Climb stairs? Will you need bandages changed or shots? If so, do you have a caregiver to help, or will you need to arrange a visiting nurse?
  • Repeat back your care instructions, to be sure you understand them.
  • Ask for a written discharge plan that lists your medical conditions, your treatments, and the plan for your ongoing care.
  • Get a list of all medications, how to use them, and what to do if you experience side effects. Be sure to ask whether to continue medications you were taking before this hospitalization.
  • Ask what symptoms suggest you're getting worse and what to do if that happens, especially at night or during the weekend.
  • What follow-up appointments will you need and when? Ask if your hospital will make the appointments for you, and send your records.
  • Do you have transportation home, to follow-up appointments, and to the drugstore?
  • If you have a regular physician, make sure the hospital sends a report of your hospital stay.
  • If you are uninsured or will have difficulty affording prescriptions, a hospital discharge planner or social worker may be able to link you to community resources that can help.
  • Get a name and number to call if questions about your hospitalization or discharge arise.
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