For Doctors: To Understand Your Patients Better, Visit Them After Hospital Discharge

If the resident physicians are allowed to observe their discharge plans in action, i.e., is in the patient’s home, they will be able to learn better, finds a new study. This can give the doctors an opportunity to evaluate patients in their homes after they were discharged from the hospital to see if the discharge plan is working for patients or not. The findings of this study are published in the journal of Gerontology & Geriatrics Education.

Thirty-nine internal medicine residents from Boston Medical Center (BMC) participated in a post-hospital discharge home visit to older patients. They were able to review their discharge plan and determine the effectiveness of the plan, specifically identifying parts that did and did not work. "After visiting the home, the residents were better able to understand what makes for good hospital discharge of an older patient," explained corresponding author Megan Young, MD, assistant professor of Medicine at BUSM.

After completing the exercise, residents were asked what they learned. These residents were able to assess better patient needs, which highlighted the need for more individualized discharge plans with regard to in-home functioning, communication with caregivers and medication reconciliation.

"By being able to go into the patient's home and see what services patients need (home-delivered meals, grab bars in the shower, medication delivery systems), we as doctors are able to provide more comprehensive care plans that allow community-dwelling older adults to stay in their home and out of the hospital," said Young, a geriatrician at BMC.

Adverse events in older adult patients following discharge from the hospital are as high as 25 percent. Since the affordable care act and hospital readmissions reduction program, many hospitals get lower payments if they have too many readmissions. "Although this study did not look at re-admissions, the goal was to teach residents how to develop comprehensive discharge plans that involved community agencies and resources in the hopes that future patients will have fewer adverse events and readmissions."

Source-Eurekalert