Everyone wants to get you home safe and keep you healthy, but sometimes going home is a bad option. It's in the medical team's best interest to discharge you when you're ready—not just to make empty beds for the next person. "There's a big push that when we discharge patients they are stable and safe," says Suparna Dutta, MD, chief of the division of hospital medicine at Rush University Medical Center. Getting out on time will also help control costs—check out what you need to know about hospital bills. She explains that government regulations on readmissions penalize hospitals if a patient returns in 30 days after being discharged. Of course, there are exceptions: If you have a chronic disease, it's likely you'll be back. But for the most part, it's their goal to get you out of there when the time is right for you—not them. That said, being discharged too early is a reality for nearly one in five patients, shows research on over 32,000 people from the University of Texas Southwestern Medical Center. (There are 50 more secrets hospitals are trying to hide from you.) Having one vital sign that's not stable, like low blood pressure, increases risk of readmission or death by 36 percent compared to fully stable patients. Having three unstable signs quadruples the likelihood of readmission. If you're being discharged, ask the doctor to verify that all your vital signs are stable. There are a few skills that suggest you're strong enough to function at home on your own, and one of those is being able to get out of bed. "If you can't, I wouldn't want to discharge you unless you have a lot of help at home," says Robert McCann, MD, a member of the University of Rochester Medical Faculty Group. You can improve your hospital stay with these 12 tips. In order to leave at the right time, you need to make sure your "big systems" are working. Can you keep food down? Can you pee? Do you have normal bowel habits? Can you get up and move a small distance? You may not feel back to yourself, says Dr. Dutta, but you should be able to accomplish the bare minimum of daily life on your own. Think about what's going on during recovery, advises Dr. Dutta. Is there something happening that can't be done at home? (For example, maybe you're getting IV medication.) Stop to consider the treatment you're getting and whether you or your caretaker can manage it once you return home. No? Ask how exactly you can make the transition safely. Before you leave, your medical team should know that your home can support any new limitations you might have. For instance, if you've recently gotten surgery and it's difficult to walk up the stairs, you may need to relocate a bed to the ground floor temporarily. "Your home set up affects how soon you're able to go home," says Dr. McCann. Make sure you understand the ins and outs of home care. One of the biggest reasons for a readmission, says Dr. Dutta, is that a patient will get a prescription for medication and then find out at the pharmacy that their insurance won't cover them. The patient may not take those meds for a couple days, and then get sick again. Her advice: During recovery call your insurance ahead of time to make sure any medication or supplies needed will be covered. If not, your doctor should be able to find a covered alternative. Consider this: You may be ready to get discharged, but you're not ready to go home, says William Wooden, MD, director of operative services at IU Health. There are intermediate facilities that you can go to, like short-term recovery facilities or rehab centers, that will help you recover. There, you can get more intensive physical therapy, nutrition support, and even emotional support to bounce back in the best way possible. After surgery or a procedure, it can both be a waiting game—and a flurry of activity that leaves you confused as to what just happened. So if you feel like the staff isn't communicating effectively and you're being rushed out, tell them that you're uncomfortable with what's going on. (Consider these tips for knowing what your doctor is really thinking.) And keep asking questions until you get the clarity you're looking for. "Most of the time, you'll find people on staff who want to do the right thing for you," Dr. McCann says. If you feel like you're being discharged from hospital too soon, your needs are not being met, or you're not being heard, you can contact the ombudsman at the medical facility. He or she is on the administration staff and addresses complaints. "Every hospital has someone to deal with these issues, but because the medical staff truly wants to help you, it's rare that this person needs to get involved," says Dr. McCann. Still, the resource is there if you need it. Source
