A new online study tracking patients after they have left
the emergency room shows that a gross majority of patients are not getting the help
they need to give themselves proper home care.
Because most hospitals do not have the infrastructure in place to
instruct patients fully on self-care procedures such as administering
medication and caring for wounds, and to then follow up to make sure patients
understand and are capable of carrying out the instructions they receive, more
and more patients are returning to the emergency room with complications and worsened
Unacceptably high rates of re-admittance to the hospital are
causing agencies such as the Medicare Payment Advisory Commission, which
influences Congress on health care policy, to make significant changes to
Medicare. Proposed policy changes
include reducing Medicare payments to hospitals whose re-admittance rates are
particularly high, and rewarding physicians who are helping their hospitals
lower re-admittance rates.
Experts say that better doctor-patient communication
techniques are the key to patient understanding. In a typical E.R., doctors doll out many of
their instructions verbally and quickly.
E.R. patients, who are typically vulnerable, anxious and upset, are
often not in the best state to receive and process complicated
information. A “teach back” approach, in
which the patient repeats his or her instructions slowly and carefully back to
the doctor, is widely accepted as one of the most effective methods of
preventing self-care errors once the patient leaves the E.R.
If implemented, the proposed changes to Medicare will
encourage our hospitals to take more responsibility for the long-term
well-being of their patients. Please call
your Congressperson to voice your support for the Medicare Payment Advisory