hospital discharge

Hospital Discharge Planning is Critical for Recovery

Posted by admin on February 4, 2012   |   No Comments

Why is hospital discharge planning so important for a successful recovery? The following example is one of many that happen frequently in hospitals.

A patient had parathyroid surgery. The parathyroid gland regulates calcium in the blood. A known side effect of this surgery is hypocalcemia, low calcium level in the blood.
The patient was discharged from the hospital without calcium supplements or instructions on potential complications and symptoms if a low calcium level develops. She returned to the hospital emergency room when her calcium level caused severe hypocalcemia symptoms. She was given excessive daily dosages of calcium and remained in the hospital until her condition stabilized. She was discharged from the hospital. Similar to her first hospital discharge, she was not given instructions on potential side effects. More importantly, her increased daily dosage of calcium was not reduced upon discharge. She went home continuing to take excessive amounts of calcium for many weeks. She returned to the hospital again when the increased calcium levels caused hypercalcemia symptoms which included kidney damage and several of her teeth fell out!

75% of hospital readmissions are preventable. Most of these are drug events which are preventable. Unfortunately, there is a breakdown of communication between medical providers, home health staff, nursing homes, family members and the patient. Medicine reconciliation is critical when you are discharged from the hospital. Typically, when you are admitted to the hospital your prescription drugs will change based on what the hospital uses. It is important for your health safety to reconcile your medications upon discharge to ensure that duplication and adverse side effects do not occur.

The Agency for Healthcare Research and Quality (AHRQ) recognizes this serious, yet common problem in hospitals and has addressed it by funding Project RED, Re-Engineered Discharge. Currently, approximately 250 hospitals are participating with more to follow. The program helps hospitals to educate patients on self-care and to improve hospital discharge communication to reduce overall hospital readmission. The program was initially developed by Boston University Medical Center to help solve their own discharge planning problems.

Common questions addressed in successful discharge planning include:

What should I eat?
What activities or foods should I avoid?
Where is my pharmacy?
What is my medical problem?
What are my medication allergies?
What medicines do I need to take? Why am I taking them? How much do I take?
How do I take this medicine?
When are my next appointments?
Questions for my next appointments

Remember, if you are a Medicare beneficiary and you do not feel that you are ready to be discharged or the post-discharge planning is not acceptable to you, you can appeal the decision. http://www.lifelongwellnessadvocates.com/are-you-being-discharged-from-the-hospital-too-soon/


Are You Being Discharged From The Hospital Too Soon?

Posted by admin on November 28, 2011   |   No Comments

Many people do not know their patient rights if they feel that they are being discharged from the hospital too soon. If you think that it is medically necessary for you to stay in the hospital a little longer or if the transition to post-hospital services is not acceptable to you, you can appeal the decision for your discharge.

Medicare beneficiaries are able to utilize this appeal process since Medicare wants to ensure that each patient is receiving timely, quality health care. Medicare hires a Quality Improvement Organization (QIO) in each state to address health care quality concerns for their beneficiaries. The Center for Medicare and Medicaid requires hospitals to notify patients of their rights to appeal a decision for discharge. This written notification, which is called Important Message from Medicare, must be given to all patients to review and sign within the first 2 days of hospital admission. If you are in the hospital for more than 3 days, you will receive the notice again no less than 4 hours prior to your official discharge.

The timing that you file your request for appeal is crucial for the discharge process and has financial implications that affect you. If you have received official notice of your discharge date and you think it is premature, you must request your expedited review by noon of the next day. You must make your appeal no later than midnight on the date you are to be discharged while you are still in the hospital.

How do you appeal? The process to start the appeal is easy. All of the information is provided in the Important Message from Medicare notice that you reviewed and signed, or someone with your permission did on your behalf. The contact information for the QIO in your state is listed on the notice as well as instructions on how to file your complaint. The QIO that serves Colorado is the Colorado Foundation of Medical Care. Their direct phone number for the Medicare Beneficiaries Hotline for Complaints and for Expedited Review Requests is 800-727-7086.

How does this affect you financially? You can stay in the hospital while Medicare pays for your care until your appeal decision has been determined. Medicare beneficiaries are not financially liable for hospital costs while their case is being reviewed by the QIO (except co-pays and deductibles). If the QIO agrees with you that it is too soon for you to be discharged, then you can stay in the hospital and Medicare will cover your costs. If the QIO agrees with the hospital’s decision for your discharge, then you will be required to pay all hospital bills beginning at noon on the day AFTER notification of the decision was made. Patients do have the right to request an expedited reconsideration if they do not agree with the QIO’s decision. Initiating the appeal process buys you some time and can save you money while the QIO reviews your case. Typically a decision will be made within a few days. If you decide to not appeal the hospital’s decision for your discharge and you continue to stay in the hospital, you will be required to pay all hospital bills after the official discharge date.

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