Why hospitals should pay more attention to how patients are discharged

When older adults who are critically ill frequently move between the hospital and other settings, compassion from physicians during care transitions can go a long way, a study examining patients' and caregivers' experiences with these transitions found, according to Kaiser Health News.

Seven insights from the report:

1. When physicians show compassion toward patients and their wishes, taking the time to sit with them and talk openly about their conditions, it can be a turning point for patients and their families during care decisions.

For Judy Garrett's father, there was no hope of recovery from kidney failure, Kaiser Health News reports. When Ms. Garrett's father listened to his physician tell him this, he made the decision to go home, where he died peacefully.

"This doctor showed us the reality of my father's condition," said Ms. Garrett, gratefully recalling the physician's compassion.

2. Patients and caregivers also want to feel prepared to look after themselves or loved ones after leaving the hospital and want to know their needs will be met until they recover, research recently published in Annals of Internal Medicine found.

3. This kind of caring is what older adults want after becoming seriously ill and having to move between care settings, but hospitals often don't meet these expectations, despite strategies to cut preventable readmissions, Kaiser Health News reports.

"Despite millions of dollars of investment and thousands of hours of effort, the healthcare system still feels very hazardous, unsafe and stressful from the perspective of patients and caregivers," Suzanne Mitchell, MD, assistant professor of family medicine at Boston University School of Medicine and lead author of the Annals report, told Kaiser Health News.

4. Dr. Mitchell is part of a team of experts leading Project ACHIEVE, a five-year, $15 million study examining how effective interventions to improve care transitions are. The project focuses on what Medicare patients and caregivers need and want after they return home from a hospital stay.

5. The project involves asking people undergoing care transitions about their experiences, including what went well and what didn't. Results from a survey of over 9,000 patients and 3,000 caregivers will be published this fall.

6. Project ACHIEVE found several areas for improvement from people who participated in focus groups and in-depth interviews, such as physicians addressing what patients really want to know by giving actionable information, health professionals making simple gestures to show patients they care about their well-being and collaborative planning.

7. "Patients and families tell us that once they leave the hospital, they don't know who's responsible for their care," said Karen Hirschman, PhD, an associate professor and NewCourtland Chair in Health Transitions Research at the University of Pennsylvania School of Nursing in Philadelphia.

One way to address this issue could be giving patients the name of a person to call with questions, giving them access to emergency assistance when needed.

"It's not just 'Now you're home and we called you a few times to follow up,'" Dr. Hirschman said. "It can take much longer for some patients to recover, and they want to know that someone is accountable for their well-being all the way through."

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