It seems that Medicare’s focus on reducing readmissions to hospitals is stimulating renewed attention to hospital discharge planning and communications. I’ve found it shocking how patients are often abruptly transitioned from high tech, high touch hospital care to their homes with minimal discharge instructions or after receiving information that’s on a 10th generation photocopy and barely pertains to their case.
Most of the discharge initiatives are your very basic blocking and tackling: making sure all the relevant information is organized, having a nurse go over it with the patient, and having someone call a day or two after discharge to make sure things are well understood. When you think about it, reimbursement really is a factor in why discharge communications have been so poor in the past. It takes a lot of time and patience to do it right and isn’t a revenue generator. Meanwhile it diverts resources from money making inpatient activities. That calculus changes somewhat when prevention of readmission becomes a factor in hospital profitability.
The Wall Street Journal has a good summary of the situation in Don’t Come Back, Hospitals Say. Among the programs featured:
- An animated “virtual discharge advocate” named Louise who helps explain home care to departing patients
- Transition coaches who call patients 2 or 3 days after discharge
- Project RED (for Re-Engineered Discharge), which provides individualized instruction starting well before the patient leaves the hospital
Early results suggest these approaches can reduce readmissions by 20 to 30 percent, which is a shockingly high figure considering how basic such steps are.