The 5 Things You Must Know Before Leaving the Hospital

Hospitalizations have become an accelerated process, and today's medical practitioners are often too busy to go over all of the specifics.

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There are days in our lives that bring great joy to our hearts and a smile to our faces. Like the first day of school, with all of the anticipation of the new year, or the last day of school, with the summer months just waiting for us to relax. Our wedding day and the birth of our children. Then there is the day we get to go home from the hospital after a surgery or sickness. We view this day as a major step from illness to recovery, but it is also a potential disaster for the ill-prepared.

Hospitalizations have become an accelerated process and are described by Edmund Pellegrino in his essay on human dignity as "today's mechanized experience of illness." Hospital stays are getting shorter every year and discharge doesn't occur when you are healed, but instead at a point where you can go to a less expensive location to recover. Most commonly, that place is your home. The only guaranteed aspect of your transition home is that it will not go as planned. You will be bombarded with more information than you can keep straight. My wife and I just went through this process, and even though I am a physician, there have been multiple times when we have looked at each other and asked, "What do you think he/she/they meant?"

Hospitalizations have become an accelerated process and are described by Edmund Pellegrino in his essay on human dignity as "today's mechanized experience of illness."

Many hospitals, including the one where I am the medical director, have worked hard to improve the discharge process. But despite our efforts, our patients and families consistently rate it as one of the least satisfactory aspects of their hospital experience. In an attempt to reduce the number of patients who are readmitted to the hospital less than 30 days after they leave, Medicare and other insurers have focused on this process, and next year will begin penalizing hospitals if a patient returns.

THE 5 THINGS YOU MUST KNOW

Medicare has created "Your Discharge Planning Checklist" (PDF). This six-page document lists 22 different areas to cover with your doctor and health care team. In an ideal world, medical professionals would help you go over all of these points. But, in the excitement of getting to go home, few of us are likely to make it through the whole list. Here's my top five.

MEDICATIONS: It seems obvious, but this is the greatest source of confusion. You have the medicines at home that you were taking before you came to the hospital. When you checked into the hospital, these same medicines may have been changed to a generic or another equivalent medication that was substituted for the one you took at home. You may not be aware that the new prescription that the doctor gives you at discharge is really the same medicine you've been taking before. This may put you at risk to take a harmful double dose. You need to have your nurse or doctor carefully go over your old and new list to make sure everyone is on the same page. Another tip: Only use one pharmacy, so that the pharmacist will have a record of all your medicines and can identify any potential problems. Have the hospital or pharmacy fax your final list of medications to your primary doctor. So often the doctor who takes care of you in the hospital is not the doctor who will follow you once you go home.

Presented by

Richard Senelick

Richard C. Senelick, MD, is a neurologist who serves as medical director of the Rehabilitation Institute of San Antonio. He is also editor in chief of HealthSouth Press. More

Among his many books and publications, he has authored Living with Stroke: A Guide for Families, Living with Brain Injury: A Guide for Families, The Spinal Cord Injury Handbook, and Beyond Please and Thank You: The Disability Awareness Handbook.  .

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