Nobody wants to go through a traumatic medical event of any sort. To experience a heart attack is difficult enough, but to be on the road to recovery and then to be readmitted into the hospital for heart failure related complications is something that no one wants to go through. However, it is an all-too-common course that people end up on. In fact, it has made such waves that the government now tracks the readmission rates for heart attacks, heart failure and pneumonia whether it is to the original admitting hospital or a subsequent one.
Patients and the government are not the only ones who do not like this trend; hospitals are economically burdened not only with care of the patient but also redirection of healthcare staff at possible critical times. In order to prevent readmissions for cardiovascular occurrences, a new mindset needed to be understood and implemented.
It is believed that one out of every five Medicare patient is readmitted within the first 30 days after initial discharge following a heart attack or similar event. On a grand scale, that means that billions of dollars are being spent to take care of these patients once again. The solution might be as easy as understanding the patient as a whole. The patient might be dealing with much more that cardiovascular problems, but also might be at risk due to outside emotional, mental, psychological, financial or even educational issues. If a patient is not able to understand the discharge information presented to them because they are unable to read or the language is above their reading or language comprehension, then it is very possible that critical directions will not be followed. Or if the patient believes that subsequent appointments with doctors are going to cause a financial burden, appointments will either be ignored or never scheduled.
A new mentality needs to be identified and utilized in order to ascertain which patients may fall into one or more of these risk areas, and thus ultimately end up back in the emergency room and hospital. In more basic terms, sending someone home after a hospital stay with instructions to follow, medications to pick up and other detailed objectives and then not checking up to make sure all is being completed is not sufficient. No one needs to fall through the cracks, but effort should be made on the part of health professionals to intervene more into the lives of patients who have suffered a heart attack or other cardiovascular episode.
It is not possible to hold the hand of everyone that is being discharged from a hospital, nor is it necessary. However, there are target focuses that will help to ensure that at-risk patients are getting the care they need, and confident patients are not being burdened with too much involvement. These are the three areas of both concern and overall best assessment:
- Medication optimization
- Early follow-up care coordination
- Enhanced patient education
All medication being taken and prescribed should be appraised for reactionary concerns, and the patient needs to fully understand when and how all medicines should be taken. This may sound like common sense to most people, but at times of stress and duress, going over all aspects of medications helps a patient to grasp the complexities, side effects, and reactions that may occur. ACO’s try to manage all risks, especially when they involve heart failure.
Early follow-up care coordination is an essential tool to making sure the patient is not left to taking care of themselves and possibly missing out of crucial care from health professionals. It doesn’t matter if the patient forgets to schedule appointments or chooses not to make them; follow-up coordination helps to make certain the patient receives the care that will alleviate the chance that he/she would be readmitted back into the hospital.
The enhanced patient education goes directly to making sure the patient is aware of all aspects of their condition. This focus area can be minimal if a patient is well informed already, or could be extensive if a patient has little or no understanding depending upon a great number of outside issues, which could range from literacy to language or a variety of other matters.
No patient wants or should be unnecessarily subjected to recurring hospital stays, especially if there are methods available to mediate this problem. Implementing focuses like the ones listed above may require more time upfront, but that would mean that time and resources will be saved down the road.