Being hospitalized is no picnic, so it’s usually a relief when you receive the news that you are ready to go home. You’re likely to feel excited and start creating a list of things you want to do once you get back. Yet for most people, understanding why they were hospitalized and which medical follow-up is necessary are not included on the list. Here are the three things you should do before you leave the hospital:
1. Keep a hard copy of your discharge instructions.
In addition to a copy of your discharge instructions, the National Patient Safety Foundation encourages everyone to ask these three main questions with the answers available in writing:
- What is my main problem?
- What do I need to do once I am home?
- Why is it important for me to do this?
In a cohort study from Yale-New Haven Hospital of 395 patients of age over 65, fewer than 60 percent were able to describe their diagnosis after leaving the hospital. Read your discharge instructions carefully so that you can answer those three questions. If not, you should speak with the nurse or your doctor.
2. Make sure you have a follow up appointment with your primary care provider and, if applicable, a specialist.
In that same study, almost half of the patients did not recall the details about their follow-up appointments (it was not clear from the study if the patients did not receive the appropriate discharge information or if they forgot what they were told). Most people have medical conditions that are chronic and are not completely resolved during hospitalization (for example, diabetes, chronic lung disease, or heart disease). That means that any changes in your medications during the hospitalization will need careful follow-up at your next doctor appointment. Unfortunately, this critical follow-up appointment does not happen as often as it should. In a study involving national data of over 11 million Medicare participants, only about half of patients who needed rehospitalization within 30 days had had a follow-up visit. Make sure your necessary appointments are scheduled before you are discharged.
3. Ask your nurse about how you can make sure your doctor receives your discharge summary.
Right after your discharge, your inpatient doctor will write up a discharge summary that discusses your hospital course, new medications prescribed, and laboratory or imaging studies. It is critical information for all your providers. Unfortunately, the discharge summary does not always get to where it needs to go. In an analysis that combined results of multiple studies, up to 88 percent of the discharge summaries did not reach the appropriate primary-care doctor by the time the patients had their follow-up appointments. Before you leave the hospital, ask the nurse how you can be assured that the discharge summary will be sent to your primary-care doctor and, if appropriate, specialists. Even better, have the hospital additionally send you a copy of your discharge summary and bring it to your doctor’s office.