Physicians and nurses tell patients how to take their medications before they leave the hospital. But many patients find these instructions confusing and may not really understand what medications they're taking, why they are taking them, or how to take them properly. The result: They take the medications incorrectly-or not at all-and end up back in the hospital.
A case manager at a meeting described how the family of a patient was pressuring her to change the patient from outpatient services to inpatient status. If she didn't help, the family pleaded, the patient would face higher costs for postacute care. The case manager bragged about how she held the line, despite the tears. However, others in the room didn't think the details of the case were as black and white as the case manager claimed. And some wondered whether "holding the line" at any cost is really what a case manager should be doing.
High-risk Medicaid patients who received transitional support after hospital discharge were 20% less likely to wind up back in the hospital during the following year, according to a new study.
If you're looking to reduce your readmissions-and let's face it, who isn't these days?-it may be time to take some tips from organizations that have had success.
By now you've probably gotten a good look at the 2014 IPPS Final Rule changes to the inpatient admission guidelines, which CMS released in August. It's time to put these changes into practice.
Doctors might know what's best for their patients, but patients don't always choose to follow that advice. Over these past few issues, CMM has talked about CMS' new suggested best practices, which were included in revisions to the discharge planning section of the CMS State Operations Manual. These new recommendations call on facilities to carefully investigate patients' refusals to heed medical advice and document their reasons for doing so. However, there is more you can do when a patient balks at a physician's instructions, says Wendy De Vreugd, RN, BSN, PHN, FNP, CCDS, MBA, senior director of case management at West Region Kindred Healthcare, Hospital Division.
