A considerable amount of media attention has been focused recently on the alarmingly high 
readmission rates at U.S. hospitals. According to a report from the Robert Wood Johnson Foundation, one in five elderly patients is back in the hospital within 30 days of being discharged. Many of those return visits are avoidable, resulting from what the report calls “a fragmented system of care” that’s based on discharge information that’s confusing and poorly organized.
According to the results of a study published in the Journal of General Internal Medicine, receiving clear, easy-to-understand discharge instructions plays a significant role in helping patients avoid hospital readmissions.
Conducted at Boston Medical Center, the study examined the post-discharge outcomes of 695 patients and found that patients with low levels of activation – that is, those who did not have a clear understanding of their discharge instructions and care responsibilities – were about two times as likely to be readmitted within 30 days of their discharge compared to patients who were highly activated. Patients with low levels of activation were also more likely to go to the emergency department during that 30-day period when compared to the group of highly activated patients.
Obviously, this study and others like it demonstrate the clear advantages of making sure patients are well informed when they return home after a stay in the hospital. And while the primary aim of providing patients with the discharge information they need is to help them stay healthier, there are also financial reasons. Just last year, Medicare announced it would levy $227 million in fines against hospitals it said had unacceptably high patient readmission rates. The government agency estimates about $17 billion is spent each year on readmissions alone. Most insurance companies also consider high readmission rates to represent wasteful spending on the part of healthcare facilities.
The take-home messages here are obvious: First, hospitals must take steps to decrease readmission rates. Second, one of the best ways to do that is by making sure patients are armed with the information they need to care for themselves properly during the weeks immediately after leaving the hospital, when the risk of readmission is greatest.
Today, many hospitals and other healthcare facilities are developing comprehensive but easy-to-understand discharge folders to help patients more clearly understand their care. Having a discharge folder serves three important purposes for the patient:
Organization
First, a hospital discharge folder helps organize information, which is especially important when discharge instructions are lengthy or complicated or when dealing with patients who may have difficulty remembering spoken instructions. The folder can be used to organize a wide variety of materials that are critical to the patient’s health and well-being, including:
- medication types and dosing schedules
- information about follow-up visits
- phone numbers of physicians and other healthcare providers
- wound care
- physical activity restrictions
- dietary restrictions
- use of medical devices
Easy to access
A discharge folder also keeps information right at the patient’s fingertips. Easily portable, they can be carried from room to room and even taken to the doctor’s office for follow-up visits. When a question does arise, a discharge folder makes it easy for the patient to find information or to determine what number to call to get the answers he or she needs.
Easy to find
Folders keep information in one convenient location so individual papers are not strewn throughout the home. And because it can be branded with the hospital logo and contact information, it’s easy to spot and to keep track of.
That’s from the patient’s perspective. From the hospital’s perspective, patient discharge folders serve another important purpose: In addition to helping your facility develop a reputation for great patient care, discharge folders provide clear, physical evidence that your facility is doing all it can to educate patients, minimize post-discharge complications or health issues and decrease readmission rates. By providing discharge folders to all your patients, you’re creating a “paper trail” that can be a valuable asset during an audit or any time your facility’s care practices are called into question.
As a tool for helping patients stay healthier and for helping your facility demonstrate its compliance with top-quality patient care methods, a discharge folder is a small investment that can yield tremendous benefits.
