Readmissions: The Impact of Improper Handoffs From the Hospital, Part II
In Part 1, we discussed the Readmission Impact for hospitals. Now, we’ll expand on Readmission Impacts from the perspective of the other side — the patient. Instead of the high-level overview approach we undertook with the first article, for this blog we decided on a different tack and conducted phone interviews with a couple of actual patients — one female and one male. Imagine they could be your mother and a favorite uncle. [In fact, our interview subjects really were the author’s family members, to add extra authenticity.]
We thought it would be appropriate to ask this very first question: “What do you think about hospitals? And what’s your relationship with them?” Being on the older side (above 70 years old), they both shared that they had an ambivalent opinion. “Sure, we deeply appreciate what they do, especially for us the elderly population, but each time this is a reminder that our health is getting poorer and time is flying.” When we shared our view of hospitals as complex 1000-head Hydras, they agreed: “well that’s true, but it’s a nice Hydra in that regard!”
The respondents continued describing how a hospital is such a big organization where patients, doctors and staff, marketing, insurance, and so many departments have to “dance together.” “I know we matter, I just don’t know how much. I’m just one among thousands of patients.” Moreover, the main concern is the post-discharge care:
“Once we’re released, we feel a bit on our own with our condition.”
Are they getting medical support and assistance from the hospital? Even though they both like their PCP, the respondents shared that they can’t repress the feeling of “out of sight, out of mind.” Their relationship with the hospital is even more strained by this sentiment of isolation post-discharge. Especially when often the last communication from the hospital is by the billing department, this makes the patient feel that the relationship is mainly a transactional and not a human-centric one.
“Readmissions are just troublesome”
Now the real problem occurs as follows: because the patient-hospital relationship is on somewhat rocky ground, patients often don’t contact and update their PCP as frequently as they should on their health status. And when they do, the condition is often in a worsened state which calls for either readmission or ER intervention.
When we asked respondents why they wouldn’t just go to the hospital before any complications arise, they answered “I just don’t want to go through the process of scheduling an appointment, going there again, waiting after other patients … Readmissions are just troublesome for both them and me.”
Too often many patients don’t assign fault to their own non-performance of follow-through, but instead attribute their decline in health to the hospital’s lack of care “because they were too busy with other patients.” This has the effect of further dismantling the already weakened relationship with the hospital.
This one condition hugely compounds the readmission problem
Another underlying issue which must be stated — the prevalence of depression is 6.7% of adults, and depressive symptomatology has been linked to hospital readmission. Depressive symptoms are associated with poor health outcomes and increased utilization. Patients with the double whammy of cardiac disease and depressive symptoms have especially worse outcomes.
Importantly, even many readmitted patients who do not have an official diagnosis of depression, display symptoms of depression which greatly impact the need for care. Thus, a new cycle of “increased readmission — depressive symptomatology” is created.
What can be done to restore the hospital-patient relationship after discharge?
As we saw in our interviews, once patients leave the hospital and are no longer being seen by a physician on the premises, they can be left feeling abandoned and unimportant in the grand scheme of things. But as we discussed in Part I, a solution exists that directly addresses this widely pervasive problem — a dedicated Transitional Care team.
But what exactly would this look like? Let us take the example of the Transitional Care company Onclick Healthcare. They have ONE job — to make sure that patients feel they’re not left all alone after they are discharged home. The LVN and NP from Onclick do this by focusing on regular communication with the patients and/or their caregivers to ensure their needs are being fully met. In this way, the patients feel satisfied that even though they are no longer in the hospital surrounded by medical staff, they still retain the sense that they are being taken care of and monitored, and all from the comfort and familiarity of home.
Speaking of home — patients can stay there healthy and happy instead of returning to the hospital or ER, since Onclick’s clinical team is always there for them to make sure they are adhering to their post-discharge plan of care. So to conclude our two-part series — whether you are a hospital worker, a patient, a caregiver, or a loved one — employing the services of a Transitional Care provider is a modern, efficient healthcare solution that will result in a win-win situation for everyone involved.
