As a doctor, I am indifferent to most medical problems. When my son undergoes routine outpatient surgery, the last thing I want to see is worry. However, when complications caused me to contact the surgeon who was on call, but was told that my son was “maybe well”, even I felt uneasy. For the surgeon, this seemed to be business as usual, but for my son and me, it was a frustrating start to the journey of recovery. This experience left me with an important fact: Although medical professionals may try to provide information to their discharged patients, they have hardly paid enough attention to the support these people need when they return home.
Discharged-Self-discharged
Per year, 35 million people In the United States, at least two-thirds of them can take care of themselves at home after being discharged from the hospital. Like my son, many of these people experience pain, confusion, medication side effects, and emotional trauma after hospitalization or outpatient surgery. Many times, they can only meet these challenges on their own, and many people are trying to do this.As a result, nearly 20% of home discharged patients were re-admitted, more than one-third Transition to a higher cost setting. Rehabilitation does not only cause harm to the patient; it is a drain on the entire healthcare system.
My experience as a doctor, as a patient, and as a caregiver gave me insight into why patients feel abandoned after they leave the hospital. On the one hand, when I conduct family nutrition support visits to patients in gastroenterology and nutrition practice, I am impressed with the ability of patients and their families to be competent to accept the complex instructions they receive. But on the other hand, I am often shocked by the fact that these instructions are given without regard to the life background of the people who must follow the instructions.
We take it for granted that even for simple outpatient procedures, such as colonoscopy or endoscopy, we all need someone else to take us home. After all, anesthesia has lingering effects, including amnesia. However, if you are not awake enough to drive home by yourself, can you really understand the self-care instructions given when you walk out of the hospital? After returning home, to what extent can you comply with the agreement? Once the fog starts to dissipate, what questions will come to your mind, and who will answer these questions nearby?
Separate treatment and aftercare
The trend of getting patients out of the hospital faster and even performing invasive procedures in outpatient clinics is part of a larger trend to reduce the cost of managed care. Essentially, hospitals provide patients with treatment facilities and (expensive, not particularly good) hotels. If you want to minimize costs and maximize care, you will focus on the former rather than the latter, and get people out of the hospital as soon as reasonable. This makes sense in a vacuum, but it does not take into account the nature of the recovery process and the type of support it needs in any environment.
At the same time, we have seen a simultaneous cultural shift in the medical industry, from taking ownership and responsibility for each patient — answering their phone calls, visiting them when necessary — and acting more as shift workers. Doctors and nurses are still very concerned, but if they take on tasks that are “not on their license”, they will be criticized for inefficiency. If you receive primary care, you can stay in the office instead of visiting your patients in the hospital. If you are a resident, your relationship with the patient rarely exceeds the scope of the facility. This separation of treatment and aftercare makes a seamless journey of recovery even more difficult to achieve.
Use technology to bridge the gap
Repairing the journey of recovery is not as simple as turning the clock back to the day of the visit. Today’s doctors are too expensive and too professional to perform nursing functions. But technical tools, especially analytical tools, can help hospitals understand which patients are most likely to need support and the type of support they need, so that they can provide support in a more efficient and cost-effective manner.
It can be shown that the factors that need support may be cultural, emotional or logistical, or it may be medical. If the recovering patients are new parents, will they focus more on being tender to the baby at the expense of their own wounds? Will people who have just undergone leg surgery go back to a house where the bedroom and bathroom are on different floors? Usually, the best clues can come from the patient’s subjective experience of their own recovery. If you ask someone every day how well they are recovering, any growing uncertainty they express may indicate that further questions and investigations are needed. Technology can make this daily reassessment feasible, helping doctors determine who they should re-engage with and work more closely. With the help of artificial intelligence, cases can be accurately upgraded and routed to ensure that the right practitioners provide the right support to the right patient in the right way.
This approach provides clear incentives for every member of the care ecosystem. Hospitals can improve the long-term prognosis of patients. Payers can reduce costs by reducing readmissions; better and more comprehensive care support can also make employees feel that they receive higher-quality benefits from their employers. Of course, for patients, better support for the rehabilitation journey can greatly relieve any anxiety, discomfort and pain after surgery.
Having a trusted friend or family member present to take you home after the operation is very important-but this should not be all the support you get. By creating a focused approach to the transition to the home and generally prolonging the recovery process, while taking into account everyone’s living environment, we can ensure that no patient feels abandoned by the healthcare system after leaving the hospital.
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