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TroveStreet® Wisdom

TroveStreet® Wisdom: Navigating hospital stays

Whether your hospital stay is the result of a scheduled procedure or an emergency, understanding what you can do to help prepare for and navigate your stay assures you will have the best experience possible.  Advocating for yourself lowers your risk of being readmitted within 90 days of release, which occurs in 1 of 5 instances.  And, with hospital stays for surgeries being much shorter than ever before, people are discharged before they are completely healed, resulting in care taking place by you (or by a loved one) in your home.   

Tip # 1:  Gather Important Information

What happens if you are unable to speak for yourself?  Having important information like a copy of your legal documents, list of your medications with dosages, allergies, health conditions, and contact information for family and medical providers gives emergency response workers valuable insights to the care they provide. 

Some people keep this information in a gallon size plastic bag hanging on their refrigerator.  Other people prefer to keep it in a file folder or manilla envelope.  The important thing is that loved ones and EMTs know it is available.  If you live alone, you may want to consider putting some sort of sticker or sign close to the door.  Vial of Life decals is one option people use to do just that. 

 

Tip #2:  Be Informed

Do you know what your insurance covers or doesn’t cover?  To the extent possible, have an awareness about your plan’s coverage.  If you come in through the Emergency Room, you may be taken to a room, received medical care, tests, meals, even a toothbrush…BUT it doesn’t necessarily mean you are admitted.  You may be in observation.  Some insurances require an admittance to pay the bill and won’t cover emergency room visits flagged as an observation.  Also, more hospitals are using traveling nurses and doctors to help with their staffing; if a test is ordered by one of these doctors, is it considered in-network?  Do you know what happens if you need medical care while traveling out of the state or country? 

Tip #3: Speak up

It is a good idea to have an advocate designated to be with you during an emergency room visit and hospital stays.  Identifying that person before a time of crisis is ideal (and make sure they know where your important papers are located).  Sometimes having someone with you just isn’t possible.  Either way, it’s valuable to:  

  • Make a list of your questions for doctors, nurses, and the discharge planner
  • Know who you are talking to – ask who they are, their role, and what they are doing
  • Ask to have each treatment and procedure explained so you comprehend what it is, why you are having it, and what would result if you didn’t have it
  • Request a bedside visit or phone call from the physician overseeing your care
  • If you utilize the health system’s online portal, ask for explanations of information on your online record account
  • Understand how to use the call button, telephone, television, and how to order your meals
  • Ask them to refer to you by the name of your choice – it’s not okay for healthcare workers to call you honey or sweetie unless you tell them it is

Do NOT be afraid to assert yourself if you feel like you aren’t being heard.  You are the patient, and you deserve to understand everything happening. 

Tip #4: Plan for discharge

A discharge typically involves understanding your medication use, diet and physical activity restrictions, warning signs of your condition worsening, and what to do should your recovery drastically decline.  Make sure you have a of danger symptoms to look out for, as well as the phone numbers of the doctor to call per concern. 

Regarding your medicine, hospital stays can change what meds you take and how you take them.  Before your discharge, know what the medicine is for and how it should be taken (with/without food, timing; when/how often, mixed or separate, crush or not, when to stop).  It is helpful to refer to your primary care physician before discontinuing medication and use one pharmacist for all medications, as they will be able to give your prescriptions a thorough review and determine any concerns. 

Always remember to contact your primary doctor to be seen within the week you leave the hospital.  If they tell you there are no openings, ask to speak to the nurse. Do not take no for an answer.  Also, make sure to plan for a ride if necessary. 

As you recover at home, you may not be able to do some of the daily activities.  Don’t be afraid to ask for help from family and friends.  Also, Medicare will pay for home health care if you are homebound, need care, and have a doctor’s order.   

What happens if discharged to a rehab or skilled care facility, hospice care, or other major change?

Often you are asked to decide on where you want to go while in the hospital.  This is the reason it is helpful to have knowledge of rehab facilities in the area to ensure the facility is the best fit for you.  Set aside some time to learn what rehab and skilled care facilities are in your area.  When selecting a place for rehabilitation, things to consider include:

  • Does the facility meet your rehabilitation needs and offer the services you require?
  • Does your health insurance cover the therapy or services you need?
  • Does the facility setting work for you?
  • How experienced are the physicians, nurses, and staff?
  • What are the quality outcomes of the facility?

Note, unless you have been admitted to the hospital for three days, Medicare will not pay for skilled care. 

Remember, you can “fight” a discharge if you feel it isn’t safe. The hospital may try to discharge you before you feel ready to go.  If this happens, talk to your treating physician and if they are not available, demand that they be contacted.  Go up the chain of command.  Tell the discharge planner that the discharge is not safe and you are concerned about your safety. 

Tip #6: Keep and update a health record

Your health is your responsibility; you are the most accurate source of information as only you know the entire story.  Keeping a record will provide a record for others when you are ill and treatment will be faster.  Your record should include up-dated information such as:

  • Illnesses or problems, dates, and treatments
  • Medications, including herbs and vitamins (and keep track of any allergic reactions)
  • Hospital stays, dates, why you were there and what happened to you
  • Immunizations; oral health care, eye examinations, procedures, physicals, etc.

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