With the advent of new penalties for hospitals in an effort to reduce readmissions, it is critical to explore post-hospital syndrome, its causes and prevention.
Post-Hospital syndrome is the condition of a patient after being treated in a hospital. About 20 percent of Medicare patients who receive treatment for an initial condition such as heart failure, COPD or pneumonia are readmitted within 30 days for other acquired conditions. The secondary conditions may include mental illness, heart failure, pneumonia, or gastrointestinal disturbance, to name a few.
In addition to attempting to recover from the initial cause of admission to the hospital, patients are often battling other factors as well which contribute to post-hospital syndrome. In order to reduce the incidence of readmissions, it is important to examine these factors.
Factors Linked to Post-Hospital Syndrome
One cause that has been linked to development of a secondary condition requiring readmission is the poor sleep habits of patients when hospitalized. Due to various reasons, patients may experience sleep deprivation. Sleep deprivation, research has repeatedly shown, can result in myriad other conditions such as cognitive impairment and a decrease in physical performance as well as metabolic disruptions. All of these can contribute to a greater risk of developing secondary conditions requiring readmission.
Poor nutrition during hospital stays has also been attributed to readmission. While in the hospital, many patients receive reduced levels of nutrition, sometimes to the extent of not being able to eat at all for periods of time. As a result, the patient may experience great weight loss or may develop gastrointestinal disturbances. This malnutrition may also cause any number of bodily reactions such as poor healing of wounds, a greater chance of infection, and cardiovascular conditions.
The treatment of pain can be associated with increased risk of readmission for secondary conditions. Often, patients are not adequately treated for pain during or after admission. As a result, sleep deprivation can occur. Using medicines in dosages that result in under-sedation of the patient can cause immunosuppression and hypercoagulability. Additionally, medicines prescribed for pain that are overly sedating may cause cognitive impairment or even post-traumatic stress disorder.
The stress of a hospitalization can also cause distress to the patient. Fluctuation of schedule and the overload of information for the patient can cause confusion and stress and ultimately can lead to delirium upon discharge.
Steps to prevent Post-Hospital Syndrome
A variety of steps can, and should be taken to prevent Post-Hospital Syndrome. The first step is to ensure top quality care while the patient is in the hospital.
Doctors and nurses should be acutely aware of the factors that cause post-hospital syndrome and react appropriately. Some issues are easier to immediately address. For instance, evaluating the causes of sleep deprivation in a specific hospital environment, and eliminating the factors that may cause it in each patient, to the extent it is possible, can directly affect patients' ability to more quickly recover after discharge. Similarly, analyzing the food that is provided for patients and making modifications that assist patients in maintaining weight and normal gastrointestinal functioning will help patients to be strong enough to recover more quickly and to fight off potential secondary infections or conditions. Also, attempting to eliminate some stressors during a patients visit by providing information in an organized way, providing detailed written information for a patient upon discharge, and normalizing schedules as much as possible while a patient is hospitalized can help to prevent cognitive impairment upon release from the hospital.
Finally, providing personalized follow up support to patients for the 30 day period, and beyond, can provide meaningful assistance that can help a patient to seek preventative help, dosage modifications, and other advice that can dramatically reduce the Post-Hospital Syndrome and readmission. Finding the right placement for those leaving the hospital can, therefore, be a major factor in preventing this condition from developing.
About the Author
Christy Rakoczy has a JD from UCLA School of Law and an undergraduate degree in English Media and Communications from University of Rochester. Her career background includes teaching at the college level as well as working in the insurance and legal industries. She is currently a full-time writer who specializes in the legal, financial and healthcare sectors. Ms. Rakoczy writes online content as well as textbooks for adult learners.