- CATEGORIES: Charu Raheja, PhD,Doctors and Hospitals,Improve Your Practice,Nurses,Ravi Raheja, MD
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How Nurse Triage Helps After Patient Discharge
Hospital readmissions are defined as cases where a patient is readmitted to a hospital within 30 days of their previous stay. Readmissions are costly for both patient and hospitals, and a potential detriment to patient health. Yet, roughly one in five Medicaid patients find themselves returning to the hospital within thirty days of their most recent hospital treatment. Most patients who are readmitted suffer from one of five conditions: heart attack, heart failure, pneumonia, chronic lung problems, or elective hip or knee replacements. “Readmissions [alone] totaled 42 billion in spending in 2014.”
Why Hospital Readmissions Occur:
A common cause for readmissions is poor follow-up by the patients after the procedure. The stress and difficulty faced by the patient during their hospital stay makes it common for them to forget or misunderstand the instructions given by the providers during the hospital discharge. Often times, patients go home confused about their medication orders, don’t follow the treatment plan, or neglect to follow-up with a doctor visit in a reasonable time frame.
Family members may be able to help patients follow discharge instructions, but they are often distracted because of the hospitalization or not be able to help with the patient discharge plan once the patient goes home.
A Plan for Decreasing Patient Readmission Occurrences
Hospitals and practices that decrease patient readmissions by following this two part process:
- Review discharge instructions after patient gets home:
A trained medical professional who can go over the discharge instructions once the patient goes home can help decrease patient confusion and increase compliance with discharge instructions. Ideally this should be done within 5 days of the patient’s release and then again about 10 days later depending on the severity of the patient’s condition during the hospital visit. The medical professional going over the discharge instruction should also be prepared to answer additional medical questions that the patient may have during the call.
- Give access to a trained medical professional 24/7:
Studies show that patients who have tools and access to a registered nurse are more likely to follow instructions, decipher the appropriate level of care for their symptoms, and stay away from the ER. (see for example, https://triagelogic.com/patient-self-management-tools-decrease-healthcare-costs/). Having nurses available for the patients gives them the confidence to stay home and allows them to call and ask questions any time a symptom arises.
Patients often ask medical questions when receiving the phone call post discharge. The medical professional needs to be trained in triage and prepared to handle questions and determine if the symptoms presented by the patient are normal and expected from the procedure, not related to the procedure, and if they they require special attention or follow up.
An outsourced nurse triage service can be a strong partner in making discharge calls and being available for patients for follow up questions. Triage nurses are trained in evaluating patient symptoms using guided protocols and they can also send reports from the triage encounter to providers to allow for follow ups and continuity of care.
Studies have shown that, when patients receive proper follow-up after discharge, they are less likely to be readmitted to the hospital and are more confident and satisfied with the care provided to them. Telephone nurse triage used for patient discharge follow-up drastically reduces patient confusion, hospital readmissions, and overall cost of care while also guaranteeing full continuity and high quality of patient care.
 Rau, Jorda, (08/03/2015), Half of Nation’s Hospitals Fail Again to Escape Medicare’s Readmission Penalties, Retrieved from: http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/
 Hodin, Michael (10/19/2015), This Hot New Technology Can Save Medicare, Retrieved from: http://www.thefiscaltimes.com/columns/2015/10/19/hot-new-technology-can-save-medicare/
 Budryk, Zack (10/13/2013), Follow-up With Patients After Discharge, Retrieved from: http://www.fiercehealthcare.com/special-reports/follow-patients-after-discharge
What to read next: Improve Healthcare Access and Reduce Hospital Readmissions