Making Sure Our Patients Know What to Do When They Go Home

It is very hard for a patient to know precisely what they should do and what they should look out for when they are discharged from the hospital. I have spoken many times, in this blog, about the biggest failing of the U.S. health care system being its inability to efficiently coordinate care for those with chronic disease. Patients are often not sure what to do in the transition from inpatient to outpatient. (This morning, I learned of a patient who had prescriptions for 48 separate medications when she arrived at our hospital!)

To try to get U.S hospitals to fix the problem of poor coordination and other issues, the Center for Medicare and Medicaid Services (CMS) requires that hospitals participating in Medicare participate in the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey. The survey has 32 questions ( seven of them are demographic) that ask about things like care from nurses, care from doctors, cleanliness and communication. There are two questions that directly inquire about the discharge process for those not going to another health care facility. The questions are: “During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?” and “During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?”

I encourage all blog readers to go to the Hospital Compare website and see how GBMC measures up against others on HCAHPS and other quality of care metrics:
https://www.medicare.gov/hospitalcompare/search.html

Well, since our outstanding physicians, nurses and other staff members have been testing changes to better inform our patients when they are going home, like having the physician and nurse give the instructions together, we have made great progress! Just look at this run chart that combines the score on the two questions:

We are not at perfection yet…this work is difficult….but we have made great progress. Please join me in thanking our great clinicians for helping our patients to better understand what they need to know when they get home.

Our Housekeepers Are Preventing Infections!
We have now gone twenty-four days without a hospital-acquired Clostridium Difficile (C. diff.) infection. This is a fantastic accomplishment. C. diff. is a serious infection that causes abdominal pain and diarrhea that can be severe. Our Environmental Service team began a test of change recently where they are now sanitizing all rooms of discharged patients with bleach and it is working! Please thank our EVS staff when you see them. They are truly helping us treat everyone every time as it they were our own loved ones.