Your Health Hospitals Strive to Make Patients More Comfortable
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Even if you’ve managed to avoid hospitals for most of your life, as you age chances increase that you’ll require a hospital stay. But there may never be a better time to have surgery, because hospitals are working to be more responsive to patients. Click here to view article.
Hospitals strive to make patients more comfortable
Even if you’ve managed to avoid hospitals for most of your life, as you age chances increase that you’ll require a hospital stay. You may dread hospitals because you either know firsthand or have heard how unpleasant the experience can be. Popular stories often revolve around acquiring infections and getting sicker from being in the hospital, being discharged too early or not being able to get a good night’s sleep.
But there may never be a better time to be in the hospital, because hospitals are working to be more responsive to patients. Motivated partly by patient satisfaction surveys that are tied to Medicare payments and partly by increased competition, hospitals are taking action. They strive to make surgery safer and be more responsive to patients’ emotional comfort. Initiated in 2012 and tied to the Affordable Care Act, Medicare financially rewards the best-performing hospitals, based on the surveys. Because private insurers typically follow Medicare’s lead, it’s expected they, too, will eventually tie reimbursements to patient satisfaction.
In addition, hospitals are asking their nurses to complete more education and training, such as a bachelor of science in nursing and specialized certifications. Overall, hospitals are more likely today to value nurses’ input, as it is the nurse who has the most daily contact with patients and families. The goal is to facilitate greater whole-person care, which helps in the healing process.
Seeking Patient Input
The satisfaction survey asks patients about communication with doctors and nurses, hospital staff responsiveness, pain management, information received about medicines, whether the hospital was clean and quiet and about discharge and transition of care to a home or facility.
Because noise consistently gets the worst marks on patient surveys, hospitals are working to create a quieter environment. They are replacing overhead staff paging systems with wireless headsets, allowing patients to shut room doors and ask not to be disturbed, and installing white-noise machines and sound-absorbing ceiling tiles and carpets in rooms and corridors. In some units, routine checks of vital signs are not done unless necessary (from “Hospitals Work on Patients’ Most-Frequent Complaint: Noise,” June 10, 2013, Wall Street Journal.
Making Patients More Comfortable
Several hospitals are even working to reduce patients’ emotional distress that results from insensitivities in the care system. “The effort is driven partly by competition and partly by a realization that suffering, whether from long waits, inadequate explanations or feeling lost in the shuffle, is a real and pressing issue,” according to the New York Times (“Doctors Strive to Do Less Harm by Inattentive Care,” Feb. 17, 2015).
When medical staff started asking patients about causes for their distress, they heard about a doctor bluntly telling a patient he had cancer and the loss of privacy when a doctor discussed a patient’s medical condition where others could hear, a violation of HIPPA regulations, which can also place the hospital under risk of litigation. One hospital posted the patient satisfaction scores for its doctors, nurses and other workers, which galvanized the staff to improve their performance—and ratings.
Safer Surgery
At the same time, hospitals are trying to make surgery safer for patients. According to an analysis last year in the journal Patient Safety in Surgery, 46-65 percent of adverse events in hospitals are related to surgery, especially complex procedures (as reported in the Wall Street Journal, “How to Make Surgery Safer,” Feb. 16, 2015).
Not only are surgical errors harmful to the patient, but hospital finances suffer. One study reported that malpractice claims against hospitals over a 20-year period (1990-2010) resulted in $1.3 billion in payouts (Wall Street Journal). In addition, upcoming changes in Medicare payments (starting at the end of 2018) will base 50 percent of Medicare payments to doctors and hospitals on the quality of care they provide, rather than the quantity.
To track surgeons’ performance and learn best practices, hospitals are collecting more data about surgical errors. They’re educating surgeons about the equipment they use, as well as working to create a culture of safety in the operating room. On the patient end, hospitals are trying to predict which patients have the highest risk of complications from surgery or anesthesia. When patients are in poor health to begin with, hospitals may delay elective procedures until patients are stronger.
Avoiding Patient Readmissions
One reason for patient suffering—or at least inconvenience—is being discharged too early and having to return to the hospital for more care. Nearly 1 in 5 Medicare patients returns to the hospital within a month of discharge, costing Medicare $17.5 billion in additional hospital bills. Until recently, hospitals have had little financial incentive to ensure patients get the care they need once they leave, and in fact benefit financially when patients don’t recover and return for more treatment. Generally, Medicare pays hospitals a set fee for a patient’s stay, so the shorter the visit, the more revenue a hospital can keep.
But, in October 2012, Medicare began penalizing hospitals with excessive readmissions. As of October 2014, Medicare fined a record number of hospitals—2,610—for having too many patients return within a month, according to Healthcare Finance. Since the new regulations, many hospitals are working harder to provide patients with detailed instructions when they are discharged and to ensure that their recoveries are monitored and that they have an ample supply of necessary medications.
Guarding Against Common Hospital Errors
Hospital patients potentially face an assortment of medical complications, but you can be proactive and guard against problems. Before your hospital visit, write down your medications, the dosage for each and when and why you take them. Also list the dates and reasons for all previous surgeries/procedures.
Most important, don’t be afraid to challenge medical staff and ask questions. Experts say to never give up responsibility for your own health. WebMD advises how to deal with the six most common hospital complications. (See sidebar for suggested questions.)
- Medication errors: To prevent getting the wrong medicine or dosage, ask the health worker what a medication is and why you need it before taking it. Make sure the nurse checks your ID bracelet against the name on the prescription.
- Hospital-acquired infections: The Centers for Disease Control (CDC) report that, on any given day, approximately 1 in 25 U.S. hospital patients acquires at least one infection while in the hospital. Hospitals are full of nasty bacteria or viruses, including MRSA (methicillin-resistant Staphylococcus aureus), a type of staph infection that’s resistant to many antibiotics. To lower your risk, ask your doctor whether you’ll get antibiotics before and after surgery. After surgery, don’t let people touch you until you have seen them wash their hands.
- Pneumonia: Pneumonia is the third most common hospital-acquired infection (after urinary tract and wound infections). To clear secretions in your lungs, breathe deeply.
- Deep vein thrombosis (DVT): Surgery significantly increases your risks of DVT, which is a blood clot, typically deep in the veins of the leg. If the clot breaks free and travels through the bloodstream, it can get lodged in the arteries of the lungs, cutting off the blood’s supply of oxygen. This complication, called a pulmonary embolism, can be fatal. Fortunately, careful use of blood thinners can slash the risk of DVT without increasing your risk of bleeding. Because studies have shown that these precautions are often ignored, you should always ask about them. As soon as you are able, you can start moving around—stretching or walking—to reduce your risk of DVT.
- Bleeding after surgery: You can help prevent uncontrolled bleeding by providing a list, before your surgery, of every medication you take—vitamins, supplements and homeopathic medication. Common medicines—like the painkillers aspirin and ibuprofen— can thin your blood, increasing the risk of bleeding. If you forget and take one of these drugs, say something, because a simple blood test can check if your blood is too thin for surgery. Also mention if you’ve ever had excessive bleeding, even for something minor, like the removal of wisdom teeth.
- Anesthesia complications: Take precautions by meeting with your anesthesiology team to discuss your options. Go over the benefits and risks of local, regional and full general anesthesia.
Sources
“Medicare fines record number of hospitals for 30-day readmissions,” Oct. 03, 2014, Healthcare Finance
“Hospitals Face Pressure to Avert Readmissions,” Nov. 26, 2012, New York Times
“Medicare to Penalize 2,217 Hospitals for Excess Readmissions,” Aug. 13, 2012, Kaiser Health News
Ask Questions
In the hospital, don’t be afraid to ask questions about your care. Doing so could make your hospital visit easier and lets the staff know that you are actively engaged in your own health care. You can ask your nurse or other medical staff:
- How long do you think I will be in the hospital?
- What doctors and other medical staff will take care of my health?
- When will I see my doctor?
- What will be my daily schedule during my hospital stay?
- What will this test tell me? Why is it needed, and when will I know the results?
- What treatment is needed, and how long will it last?
- What are the benefits and risks of treatment?
- How long will I need the catheter? Can I get up and go to the bathroom with help or on my own?
- When can I go home?
- When I go home, will I have to change my regular activities or my diet?
- How often will I need checkups?
- Is any other follow-up needed?
- Who should I call if I have other questions?
From “Frequently Asked Questions,” NIH Senior Health
http://www.optimumseniorcare.com/services/alzheimerscare.php