During the transition from hospital to home health care, patients face a significant risk of adverse events which may negatively affect patient safety leading to readmission or even worsening of health and death. Events such as falls and missed doses come to mind. Ensuring that the patient's transition from home to health goes smoothly care is a collective responsibility for the medical staff, the patient and their intended caregiver. Below are some tips that could help to facilitate the process:
1. Proper information- it is important to get information about various aspects regarding the patient's condition. These include:
- A detailed listing of diagnosis and all the procedures that were performed. This comes in handy in case the patient has to be readmitted at a different hospital.
- An accurate guide on diet requirements and restrictions, treatments, post-discharge therapy.
- A list of key contacts including doctors, pharmacists and home care agency representatives among others. If possible collect their business cards for safe keeping.
- A realistic assessment of the patient's outlook- this should include expected recovery time and symptoms of relapses.
- A list of available community and hospital resources. Ensure you have information on all facilities that can handle the patient's illness.
It is vital that a high level of communication is maintained between the hospital staff and the patient even after they have been discharged.
2. Caregivers are very important- It is not safe for a patient who has just been discharged to be by themselves at home. When a patient returns home from hospital they tend to have lingering effects such as pain, dizziness and muscle weakness. This makes performing certain tasks difficult and they are especially vulnerable to falls. If you are the one being discharged ensure you have a caregiver. This can be a family member, friend or even a hired professional home care attendant. If you have a loved one coming home, consider getting caregiver training. Learn how to take care of them while they are still in the hospital so that you fit into the role seamlessly. Don't be afraid to ask hospital staff to demonstrate certain tasks and also ask their realistic expectation of what the future will be like.
3. Medication management- this is one of the most vital aspects of home health care. In most cases, once a patient is discharged the medication routine will change leaving room for errors. It is important that you verify medication by brand name before leaving the hospital so that there is no confusion in case you have to buy the medication. Ensure you understand why old medication has been stopped, what new medication does and the kinds of reactions and side effects to expect if any.
4. Prepare the patient's home and acquire the necessary home care equipment- various adaptations will need to be done to various aspects of the home to ensure the patient is as comfortable and as safe as possible. Remove excess clutter to allow easy passage and clear items such as cords and area rugs that increase the risk of falls. You may need to install a ramp in place of stairs to facilitate movement of a wheel chair. You may also need to bring in equipment such as a hospital bed, stethoscope and wheel chair among others.
5. Prepare for additional expenses- it is important to plan for how to raise additional funds required to sustain various aspects of home health care. Running out of money can be very risky since the patient may be unable to acquire required medication and other needs. Some services of home care are covered by medical insurance which may help to ease the financial burden.
6. Timing of the discharge- the patient should be discharged only when the doctor thinks they are ready to go home. Hasty discharging could prove fatal. Some patients insist on being discharged as soon as possible disregarding what is best for them. In such cases it is up to the doctor to be assertive and do what is in the best interest of the patient. In case of early discharge the hospital staff should take a keen interest in the patient's welfare. They should only be allowed to leave if there is a suitable post discharge place where they can go to and be assured of good care.
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