Back in the good-old days of 1982, I went to the hospital on Monday, had knee surgery on Tuesday, and went home on Friday. Yep, 5 days in the hospital for a pretty minor procedure, which doctors now accomplish with an “in by 6 am and home by 2 pm” schedule. In many ways, this shortened stay is great news because hospital stays are risky and expensive. But as a result of these shortened stays, many patients leave the hospital pretty sick. As a result, patients, families and home healthcare workers often have to follow complicated medication and treatment regimens. Clearly, the quality of the care patients receive at home impacts their recovery. But doctors and nurses don’t always provide all the information needed. Unfortunately, these communication issues after a hospital stay can lead to serious complications.
What’s the impact of communication issues after a hospital stay?
Researchers found found that poor communication between medical providers, as well as between medical providers and patients, was responsible for 25% of hospital readmissions. Additionally, another team of researchers found that communication issues after a hospital discharge pose a big risk for elderly patients. Yet these problems persist.
What are communication issues after a hospital stay?
Researchers interviewed home healthcare providers to identify challenges they face while caring for recently discharged patients. The participants, comprised of nurses and other healthcare workers, cited concerns regarding communication, including:
- Lack of access to patient records.
- Incomplete or inaccurate medication lists.
- Resistance from hospital clinicians about accountability.
- Primary care doctors who are often unaware that one of their patients was in the hospital.
Additionally, home healthcare providers may not receive information regarding instructions for important next steps in care. A 2017 survey of home healthcare staff found the most common lapse in communication related to the need for additional tests.
It is easy to see how these issues can lead to health problems. Furthermore, one can assume that similar problems exist when the patient is caring for him/herself after discharge, or under the care of a family member. A lack of accurate information, no matter who is responsible for patient care and well-being, is a problem.
How common is this problem?
Pretty common. The above mentioned 2017 survey of home healthcare nurses and staff found that the lack of communication is a common problem:
- 60% stated they had not received enough information to guide patient treatment
- 44% reported problems related to inadequate patient information
What can hospitals do to decrease communication issues after a hospital stay?
Hospital-based doctors must do a better job of communicating details about a patient’s stay. The patient, the family, the patient’s primary care doctor and home healthcare providers must understand all instructions for at-home care.
The researchers offered several solutions to the lack of communication, including:
- Give home-based healthcare agencies direct access to EHRs (electronic health records) and direct phone lines to contact physicians.
- Make sure hospitalists or other hospital-based doctors are accountable for home care orders until a primary care doctor can see his/her patient and take over care coordination.
- Create better lines of communication between hospital based doctors and with primary care physicians to make care transitions safer.
Furthermore, researchers found that patients with access to electronic health records (EHRs) were less likely to have problems related to a lack of information.
What should you do as a patient or family caregiver?
To reduce the risk of communication errors when you or a loved one is being discharged, follow the suggestions in our blog post Tips for Hospital Discharges. It’s important to realize that all patients can benefit from the steps outlined in this post. Therefore, if you are a patient, a family caregiver or a home healthcare provider pay attention. Above all, communicate effectively at discharge and follow up with the medical team as needed.
Communication, at every step of your medical journey, is a key to receiving the best health care possible. Read these blog posts for more information:
- 10 Tips to Communicate Better with Doctors.
- 10 Tips for a Better Medical Appointment.
- How Can You Get the Best Healthcare? Actively Participate!
- 6 Tips to Better Manage Your Care.
- Understanding Medical Information Is Harder Than Most Realize.
- Poor Communication Between Primary Care Doctors and Other Providers.
Note: I updated this post on 3-1-19.