Better transitions curb post-op complications, readmissions

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More than 40 percent of all patients who experience complications after surgery experience them at home, according to a November study in the journal Archives of Surgery, suggesting hospitals are sending patients home sooner than they should.

Researchers analyzed more than 550,000 adult patients who had inpatient general surgery procedures and found that 75 percent of the post-discharge complications occurred within 14 days of leaving the hospital.

"We live in an era where there is a pressure to discharge and to expedite care and make healthcare more efficient," study coauthor and Yale School of Medicine surgery professor Julie Ann Sosa told NPR. "Some of these complications in the past may have occurred while patients were still hospitalized. Now they occur at home."

With hefty Medicare penalties for excess readmissions, hospitals should focus on improving post-discharge outcomes, given that almost one in 10 general surgery patients return to the hospital with postoperative complications.

That doesn't mean keeping patients in the hospital longer, but rather enhanced monitoring of patients after they leave the facility, NPR noted. The researchers called for "fastidious" triage at discharge and prompt patient follow-up.

Hospitals have been implementing transitional care models and revamping discharge process to help keep patients healthy at home and prevent them from readmitting.

Robert Wood Johnson University Hospital in New Brunswick, N.J., created a transitional care program that gives patients access to a healthcare advocate as they move from the hospital to their homes, MyCentralJersey reported. Nurses review patients' medications and make recommendations about exercise and diet.

Similarly, Somerville, N.J.-based Somerset Medical Center, teamed up with eight healthcare providers and has an advanced practice nurse follow up with patients as they transfer between Somerset and acute care rehabilitation and home care, MyCentralJersey noted. The transitional care program enhances provider communication, medication management and patient satisfaction.

For more:
- check out the study abstract
- read the NPR article
- here's the MyCentralJersey article

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